Differential diagnosis of nodular skin tumors in childhood

Background Cutaneous nodular tumors in childhood can be unsettling for parents as well as physicians, particularly in cases with a rapid growth pattern. Guidelines for diagnosis are important in these common entities. Aim This article gives an overview of rapidly growing, nodular tumors of the skin commonly seen in childhood. Macroscopic, dermatoscopic and dermatohistopathological characteristics as well as recommendations for diagnostic procedures and treatment are discussed. Results Some of the tumors presented, including juvenile xanthogranuloma, mastocytoma and pilomatrixoma as well as cutaneous Langerhans cell histiocytoma, can point towards potentially existing systemic or underlying diseases. Most of the skin tumors in children are benign and need no further treatment, while the Spitz nevus, due to their overlapping morphology with melanomas of childhood, should be excised or at least continuously monitored. Discussion Despite being mostly benign and showing high rates of spontaneous regression, nodular skin tumors in children are often hard to differentiate, leading to necessary excision of the tumor for histopathological examination. The in toto excision should avoid disfiguring scars. Conclusion Pediatricians and dermatologists should be familiar with the clinical and histological features of the most common cutaneous nodular tumors in children. Entities with the potential of underlying systemic disease make further diagnostic investigations necessary.