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Newborn Rash

This document summarizes several common benign newborn rashes, including: Erythema toxicum (E Tox), which appears as red blotches that look like bug bites and will resolve on their own within a few days. Milia, which are small white-yellow cysts that appear in the first days of life and self-resolve. Acne, which presents as red bumps with white heads that usually appears in the first 4 weeks of life and does not require treatment. Miliaria, which causes sweat blisters and resolves with cooling measures. Pustular melanosis, which causes a red rash and pustules that leave dark pigment for months. Seborrheic

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91 views20 pages

Newborn Rash

This document summarizes several common benign newborn rashes, including: Erythema toxicum (E Tox), which appears as red blotches that look like bug bites and will resolve on their own within a few days. Milia, which are small white-yellow cysts that appear in the first days of life and self-resolve. Acne, which presents as red bumps with white heads that usually appears in the first 4 weeks of life and does not require treatment. Miliaria, which causes sweat blisters and resolves with cooling measures. Pustular melanosis, which causes a red rash and pustules that leave dark pigment for months. Seborrheic

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shamaarouba
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We take content rights seriously. If you suspect this is your content, claim it here.
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Benign Newborn Rashes

Karina Espinoza
Erythema Toxicum (E Tox)
● About 24-48hr babies develop red blotches, with tiny papule/pustule, looks
like a bug bite
● 1-4 mm wide
● Benign
● No symptoms, will resolve on its own
● Can be vesicular in nature, so to distinguish from HSV we make sure lesions
fade away in a few days. HSV would be vesicular, crusty.
○ If concerned about HSV ask about mom’s infection hx
○ C-section, would eliminate HSV possibility
● If scrape and look under microscope you see eosinophils
Milia
● 1-2 mm white-yellow cysts in forehead, nose, cheeks, or palate (called
Epstein pearls there)
● Appear in first days of life
● Self-resolves
Acne
● Red base with white cyst= papulopustular
● Appears on face, chest, back, groin area
● Usually in first weeks of life, around 2-4wks of life
○ RARE for it to be present at birth
● If have a baby that looks virilized, ambiguous genitalia, and acne since birth,
then consider endocrine disorder...this is a rare situation
● Tx: nothing needed! Won’t get scarring. BUT if parents want tx, then apply a
thin film of hydrocortisone 1% ointment to affected area for a short time to
clear lesions.
● Some babies w/ acne will go onto having severe acne vulgaris as teens, esp if
have family hx of teenage acne

*Note, acne has a red base, milia does NOT


Miliaria
● Sweat retention due to incomplete differentiation of epidermis and its
appendages
● 2 forms:
1. Miliaria crystallina
-clear vesicles on a skin-color base
-forehead, upper trunk, arms and neck
-resolve when not expose baby to heat as much
2. Miliaria rubra
-reddish spots on skin in neck, upper body, torso, shoulders
-resolve on their own, with cooling measures
What about using Powder? For all rashes?!
Absorbs moisture, so prevents rashes

BUT you want to just place a bit of powder on your hand and apply it to affected
area, then it will be OK

Don’t apply a LOT of powder to the baby


Pustular melanosis
● Obstruction of pilosebaceous orifice
● Blotchy, red rash with superficial pustules → erupt and leave a dark pigment
(resolves in months)
● Present at birth, in trunk, face, extremities
● Rare in palms and soles
● Common in African Americans
Seborrheic Dermatitis
● Yellow-red greasy scaling macule or papule, from 5-20mm in diameter,
coalesces into a plaque
● Found commonly in scalp, forehead, eyebrows, diaper area
● Mildly itchy
● Tx: self-resolves, but can try oils (coconut oil, olive oil) on area and softly lift
up scale with toothbrush. For esthetic reasons
○ Selenium-based shampoo, not FDA recommended
○ More severe cases, respond to ketoconazole
Cutis Marmorata
● Skin will be reticulated, looked mottled, like a net
● Essentially it’s dilation of capillaries and venules in response to cold=
immature autonomic nervous system
● Disappears w/ warming, and w/ time
● When it continues >1 month of age, can be a marker for T18, 21, Cornelia de
Lange syndrome, hypothyroidism, cutis marmorata telangiectatica congenita
Harlequin Baby phenomenon
● Half of the face becomes dark red/blue and the other side of face is pale skin
● It’s a response to changes in blood flow, when baby is anxious or stressed,
due to autonomic nervous system immaturity
● Can last for minutes, or longer
● Benign
● Fades away over time
Baby Skin Care 101
● While have umbilical stump attached, only do sponge baths
● Once stump falls off, can wash baby with warm water alone or soap free of
perfumes and dyes
● Bath baby every other day, for first few months of life
● Lotion is NOT necessary in the first weeks of life
Questions?

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