common neonatal dermatological conditions
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COMMON NEONATALDERMATOLOGICAL
CONDITIONS
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Erythema ToxicumNeonatorum
• Most common rash of full-term infant
• Appears as small erythematous maculesand papules that evolve into pustules on
erythematous bases.
• Rash occurs most often by 24–48 hoursof life but can be present at birth.
• Self-limited, resolves ithin !–" days#recurrences possible.
• $ustular %uid reveals eosinophils
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Transient Neonatal PustularMelanosis
• More commonly a&ects full-term infantsith dar'er pi(mentation.
• At birth, appears as small pustules on
nonerythematous bases that rupture andleave erythematous)hyperpi(mentedmacules ith a collarette of scale.
•
Self-limited# macules fade over ee's tomonths.
• $ustular %uid reveals neutrophils.
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Milia
• *ommon neborn rash.
• Appears as +- to -mm hite)yellopapules, freuently found on nose and
face
• ue to retention of 'eratin andsebaceous materials in pilosebaceous
follicles.• Self-limited, resolves ithin /rst fe
ee's of life.
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Miliaria
• 0eat Rash or $ric'ly 0eat. *ommon nebornrash associated ith armer climates, incubatoruse, or occlusion ith clothes)dressin(s.
• Appears as small erythematous papules or
pustules usually on face, scalp, or intertri(inousareas.
• ue to obstruction of eccrine seat ducts in thestratum corneum.
• Rash resolves hen infant is placed in coolerenvironment or ti(ht clothin()dressin(s areremoved.
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Neonatal Acne
• Seen in 21 of infants. Appears asin%ammatory papules or pustules ithoutcomedones, usually on face and scalp.
•
Secondary to e&ect of maternal andendo(enous andro(ens on infant3ssebaceous (lands.
• $ea's around + month, resolves ithin a
fe months, usually ithout intervention.• oes not increase ris' of acne as an
adolescent.
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Seborrheic Dermatitis
• *ommon rash characteried byerythematous plaues ith (reasy yelloscales.
• 5ocated in areas rich ith sebaceous(lands, such as scalp, chee's, ears,eyebros, intertri(inous areas, diaper area.
• 6n'non etiolo(y.
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•
*an be seen in neborns, morecommonly in infants +–4 months old.
• Self-limited and resolves ithin a feee's to months.
• *an remove scales on scalp ith softbrush)/ne comb.
• 7n more severe cases, antifun(alshampoos or lo-potency topicalsteroid can shorten the course
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CutisMarmorataMottlin!
• Reticulated mottlin( of the s'in thatsymmetrically involves the trun' andetremities.
• 7t is caused by a vascular response to coldand (enerally resolves hen the s'in isarmed.
• A tendency to cutis marmorata may persist
for several ee's or months, or sometimesinto early childhood.
• 9o treatment is indicated.
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"arle#uin Color Chan!e•
0arleuin color chan(e occurs hen theneborn lies on his or her side.
• 7t consists of erythema of the dependentside of the body ith simultaneousblanchin( of the contralateral side.
• :he color chan(e develops suddenly andpersists for 1 seconds to 21 minutes.
• 7t resolves ith increased muscleactivity or cryin(.
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• :his phenomenon a&ects up to +1
percent of full-term infants, but it often(oes unnoticed because the infant isbundled.
•
7t occurs most commonly durin( thesecond to /fth day of life and maycontinue for up to three ee's.
• 0arleuin color chan(e is thou(ht to be
caused by immaturity of thehypothalamic center that controls thedilation of peripheral blood vessels.
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Mon!olian S$ots
• Appear as blue)(ray macules ithoutde/nite borders.
• ;reuently seen on sacral re(ions orshoulders.
• ue to delayed disappearance of dermalmelanocytes.
• Spots typically fade ithin /rst fe years of
life, ith ma
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Suc%in! &listers
• =ullae either intact or erosionsithout in%ammatory borders
• May occur over the forearms, rists,thumbs or upper lips.
• Results from vi(orous suc'in( inutero
• Resolve ithout complications
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Dia$er Can'i'iasis
• >ery common diaper rash,characteried by a red, raised rash ithsmall raised and infected areas around
the periphery called satellite lesions .• @tiolo(y is usually irritation or
seborrheic dermatitis that can become
secondarily infected ith Candida .• *ommonly seen in infancy durin(
periods of diaper earin(.
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• *an be minimied by 'eepin( diaperarea clean, as dry as possible, ithfreuent diaper chan(es and topical
a(ents such as poders.
• :reatment ith topical nystatin,miconaole, or clotrimaole is
sucient.
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Than% (ou