Adele K. Evans

In children, cellulitis, abscess, and folliculitis of the skin of the face and neck are quite similar to presentation in the adult (see Section VIII).

Scalp

In addition to bacterial folliculitis, another common scalp infection is caused by the fungus Trychophyton spp., known as ringworm, serpigio, or tinea capitis; this involves a round reddish lesion usually associated with alopecia, which recovers after appropriate treatment. Neonatal seborrheic dermatitis (cradle cap) is very common and presents as scaly, dry, yellow-colored flaky scalp.

Ear

Simple otitis externa (OE) is common in children. Treatment of OE with ear drops is sometimes complicated by contact dermatitis (neomycin is the most frequent culprit). This presents with erythematous, sometimes vesicular, glassy or desquamating lesions and can follow a pattern where the drops have rolled out of the ear canal, down the conchal bowl, and onto the ipsilateral neck skin.

Nose

Acne is found quite commonly in the external paranasal and nasal regions. It is essentially a case of isolated follicular infection. The same process can occur internally on the skin-lined portion of the nose, called the nasal alar vestibule. Such folliculitides can be quite painful, and cellulitis rapidly ensues, producing nasal vestibulitis. Although painful, this infection is not serious, and simple treatment with appropriate anti- staphylococcal ointment is effective. However, venous drainage from the skin in this region occurs directly to the cavernous sinus, which can rarely result in central nervous system infection.

A slowly enlarging ruddy mass that often bleeds and may or may not be associated with discomfort is likely to be a pyogenic granuloma (capillary hemangioma). Although these often present during pregnancy, they can present in childhood as well. Common locations are the nose and lips.