Neonatal rashes: Difference between revisions
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==Erythema Toxicum== | |||
*Benign, self-limited (1wk) rash that occurs in 50% of newborns | *Benign, self-limited (1wk) rash that occurs in 50% of newborns | ||
*Erythematous macules develop on face, trunk, extremities | *Erythematous macules develop on face, trunk, extremities | ||
*No treatment necessary | *No treatment necessary | ||
==Neonatal Acne== | |||
*Occurs around 3rd week of life | *Occurs around 3rd week of life | ||
*Commonly on face, may also see on trunk | *Commonly on face, may also see on trunk | ||
*No treatment necessary (resolves by 3rd month of life) | *No treatment necessary (resolves by 3rd month of life) | ||
==Seborrheic Dermatitis== | |||
*Starts between 2-6wk of life; improves by 6 months | *Starts between 2-6wk of life; improves by 6 months | ||
*Greasy yellow-red scales | *Greasy yellow-red scales | ||
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**Salicylic acid shampoo (Sebulex) OR | **Salicylic acid shampoo (Sebulex) OR | ||
**Application of mineral oil followed by washing and removal of scales w/ comb | **Application of mineral oil followed by washing and removal of scales w/ comb | ||
==Atopic Dermatitis== | |||
*Must distinguish from seborrheic dermatitis | *Must distinguish from seborrheic dermatitis | ||
**Occurs between 2-6mo (somewhat later than seborrheic dermatitis) | **Occurs between 2-6mo (somewhat later than seborrheic dermatitis) | ||
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**Reduce drying of skin | **Reduce drying of skin | ||
**Liberal application of emollients (vaseline) | **Liberal application of emollients (vaseline) | ||
==Diaper Dermatitis== | |||
*Contact dermatitis VS candidal dermatitis | *Contact dermatitis VS candidal dermatitis | ||
*Contact dermatitis | *Contact dermatitis | ||
Revision as of 20:53, 11 June 2012
Erythema Toxicum
- Benign, self-limited (1wk) rash that occurs in 50% of newborns
- Erythematous macules develop on face, trunk, extremities
- No treatment necessary
Neonatal Acne
- Occurs around 3rd week of life
- Commonly on face, may also see on trunk
- No treatment necessary (resolves by 3rd month of life)
Seborrheic Dermatitis
- Starts between 2-6wk of life; improves by 6 months
- Greasy yellow-red scales
- Proclivity for scalp (cradlecap), but may find around ears, cheeks, neck
- Not pruritic
- DDX
- Atopic dermatitis, tinea capitis, psoriasis
- Treatment
- Salicylic acid shampoo (Sebulex) OR
- Application of mineral oil followed by washing and removal of scales w/ comb
Atopic Dermatitis
- Must distinguish from seborrheic dermatitis
- Occurs between 2-6mo (somewhat later than seborrheic dermatitis)
- Pruritic (may manifest as fussiness) vs seborrheic (not pruritic)
- Dry skin, erythematous papular lesions
- Face most commonly involved; nose and diaper areas spared
- DDX
- Seborrheic dermatitis, scabies
- Treatment
- Identify and eliminate triggers
- Reduce drying of skin
- Liberal application of emollients (vaseline)
Diaper Dermatitis
- Contact dermatitis VS candidal dermatitis
- Contact dermatitis
- Erythematous, macular or papular, w/ well demarcated borders
- Treatment
- Good hygiene, air drying, use of barrier creams (zinc oxide)
- Candidal dermatitis
- Erythematous w/ papular and pustular lesions and scaling around margins
- Classic finding is "satellite lesions"
- Must examine for oral thrush
- If present: Oral nystatin 2mL QID infants, 4-6mL QID children
- Administer for up to 2d after resolution of oral lesions
- If present: Oral nystatin 2mL QID infants, 4-6mL QID children
- Treatment
- Nystatin cream 100K U/gram TID x10-14d
- If use zinc oxide must apply after nystatin
- Hydrocortisone 1-2% after nystatin, before zinc oxide, may be used for severe lesions