TABLE 3

Differential Diagnosis of Acne in Younger Pediatric and Adolescent Patients

Adolescent (∼12–18 y of age)
 Corticosteroid-induced acne
 Demodex folliculitis
 Gram-negative folliculitis
 Keratosis pilaris
 Malassezia (pityrosporum) folliculitis
 Papular sarcoidosis
 Perioral dermatitis
 Pseudofolliculitis barbae
 Tinea faciei
Preadolescent (≥7 to ≤12 y of age)
 Acne venenata or pomade acne (from the use of topical oil-based products)
 Angiofibromas or adenoma sebaceum
 Corticosteroid-induced acne
 Flat warts
 Keratosis pilaris
 Milia
 Molluscum contagiosum
 Perioral dermatitis
 Syringomas
Mid-Childhood (1–7 y of age)
 Adrenal tumors
 Congenital adrenal hyperplasia
 Cushing syndrome
 Gonadal tumors
 Ovarian tumors
 PCOS
 Premature adrenarche
 True precocious puberty
Any Age
 Acne venenata or pomade acne (from the use of topical or oil-based products)
 Bilateral nevus comedonicus
 Chlorinated aromatic hydrocarbons (chloracne)
 Corticosteroids (topical, inhaled, and oral)
 Demodicidosis
 Facial angiofibromas (tuberous sclerosis)
 Flat warts
 Infections (bacterial, viral, and fungal)
 Keratosis pilaris
Medication-Induced (anabolic steroids, dactinomycin, gold, isoniazid, lithium, phenytoin, and progestins)
 Milia
 Miliaria
 Molluscum contagiosum
 Periorificial dermatitis
 Rosacea
  • Adapted from Tom and Friedlander6 and Krakowski and Eichenfield.7