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Scalp Nodules and Facial Droop in an Infant

Christopher E Gaw1, Christina S Turn2, Susan R Rheingold2

  • 1Divisions of Emergency Medicine gawc@chop.edu.

Pediatrics
|October 6, 2021
PubMed

Insights

A 5-week-old infant developed scalp nodules and facial weakness. Diagnosis was confirmed through scalp biopsy, laboratory studies, and imaging, revealing a rare condition.

Area of Science:

  • Pediatric Dermatology
  • Neurology

Background:

  • A previously healthy, term infant presented with a solitary, enlarging scalp nodule.
  • The lesion grew, and additional scalp lesions appeared over several weeks.

Observation:

  • Ultrasound revealed a hypoechoic structure, suspected to be a fluid collection.
  • The infant subsequently developed irritability, right eye closure difficulty, and facial weakness.

Findings:

  • Scalp biopsy, laboratory studies, and imaging led to a final diagnosis.
  • A right-sided facial droop involving the brow and forehead was noted.

Implications:

  • This case highlights the importance of considering rare diagnoses in infants with progressive neurological symptoms.
  • Early diagnosis and appropriate management are crucial for pediatric patients with complex presentations.

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