Codes

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

• Human papillomavirus infection / condyloma acuminata – Consider in sexually active patients or pediatric patients where sexual abuse is a possibility. Although skin biopsy is not necessary for the diagnosis of genital warts, it can help differentiate genital warts from PPPN.
• Condylomata lata of secondary syphilis – Take a sexual history and ask about a recent primary chancre.
• Bacterial infections
• Granuloma gluteale infantum / adultorum – Appears as oval-shaped, red to violaceous nodules in areas of maceration and/or occlusion.
• Candidiasis – Appears as beefy red plaques with satellite papules and superficial pustules, with or without scale.
• Langerhans cell histiocytosis – Crusted papules in a seborrheic distribution involving the scalp, ears, abdomen, and intertriginous areas.
• Cutaneous lymphoma
• Pemphigus vegetans – Look for crusted erosions elsewhere, as well as oral involvement.
• Papular acantholytic dermatosis

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Management Pearls

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Therapy

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References

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