Pediatric skin infections
Recognising impetigo, tinea capitis, scabies and molluscum while detecting serious infection.
Updated: 2026-09-13
Written for clinicians and medical students
This section is a teaching reference for doctors, residents and medical students. It is not patient guidance and not a substitute for clinical examination, and it must not be used for self treatment.
Pattern recognition
- Impetigo causes honey-coloured crusts or fragile bullae. Localised disease may be treated topically according to local resistance; extensive or systemic disease needs oral therapy and reassessment [1].
- Tinea capitis presents with scale, broken hairs, alopecia, black dots or an inflammatory kerion. Confirm with microscopy or culture where available and use systemic therapy because topicals do not penetrate the follicle [2].
- Scabies causes nocturnal itch, affected household contacts and papules or burrows at typical sites. Infants may have scalp, palm and sole involvement. Treat close contacts simultaneously [3].
Escalation
- Fever, toxicity, severe pain, rapidly spreading erythema, purpura, necrosis, orbital involvement or immunosuppression require urgent assessment.
- A boggy painful kerion risks scarring alopecia; avoid incision because it is inflammatory rather than a routine bacterial abscess [2].
- Recurrent, unusually severe or opportunistic infections should prompt review for barrier disease, diabetes, malnutrition or primary immunodeficiency.