History and skin exam can help pediatricians untangle allergic skin reactions
Dr. Peter Lio advises pediatricians to prioritize patient history and comprehensive physical examinations when diagnosing complex skin rashes in children. The guidance emphasizes distinguishing between allergic, inflammatory, and infectious causes while cautioning against over-reliance on food elimination diets or immediate medication-related assumptions.
Why it matters
Effective diagnostic strategies help pediatricians avoid unnecessary testing and restrictive diets, ensuring children receive appropriate care while identifying when a specialist referral is truly necessary.
Evaluating a child's rash can require pediatricians to distinguish among allergic, inflammatory, infectious, and medication-related causes, with the patient's history often providing the most useful starting point, according to Peter Lio, MD.
Lio, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine in Chicago, Illinois, discussed allergic skin reactions during the American Academy of Pediatrics (AAP) 2026 National Conference & Exhibition.
The differential can include atopic dermatitis, allergic and irritant contact dermatitis, urticaria, food-related reactions, and mimics such as scabies and fungal infections.
"It's a bit cliché, but the history really is king," Lio said. "The history is going to help set the tone and going to help us figure out what questions to ask next and what kind of testing to do, if any."
What clues can help pediatricians evaluate a rash?
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