Characteristic skin features can be clues to more serious underlying systemic illnesses in children. Henoch-Schönlein purpura (HSP) is the most common small vessel vasculitis in children and can be associated with considerable morbidity. Recognition of the associated palpable purpura on the skin can help make the diagnosis quickly. Similarly, identifying the skin features of Kawasaki disease (KD) in a patient with a conjunctivitis and fever can alert the clinician to the diagnosis. The diagnosis of juvenile dermatomyositis (JDM) is often delayed because the skin findings may be brushed off as an eczematous dermatitis. In the correct clinical context, redness of the face and scaly plaques on the hands and wrists should prompt consideration of dermatomyositis.

Early recognition of the skin findings is key to aid in prompt diagnosis and treatment. In this chapter HSP, KD, and JDM will be discussed with particular attention to the associated skin features. Correctly recognizing the skin findings and associating them with the other clinical features may help prevent unnecessary tests and delay in diagnosis.