It is not uncommon for children to present with an unusual rash or for parents to be concerned about skin lesions or birthmarks on a child’s skin. In some cases the rash will be acute, due to infection, allergy or skin irritation. In other children the skin changes may be part of a chronic condition or even a marker for a neurocutaneous syndrome such as neurofibromatosis or tuberous sclerosis. In babies, skin lesions may be due to congenital naevi.

While the diagnosis of skin lesions often depends on pattern recognition and having seen similar lesions before, it is important to approach this problem with a systematic, logical approach. It is also important to be able to describe the lesions appropriately, either when seeking second opinions (e.g.from a dermatologist) or consulting databases and textbooks to establish the diagnosis. Following a systematic approach is likely to reveal the diagnosis and prevent the need for requesting further investigations or causing unnecessary anxiety.