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Erythema toxicum neonatorum
Macules, papules and pustules appeared 24 hours after birth in this healthy baby. Gram stain of the pustules showed numerous eosinophils. The eruption resolved without treatment.
In some cases, pustules are sparse.
An extensive case with red papules on an erythematous base. A few pustules were also present.
Scattered papulovesicles with an erythematous flare. A smear of intralesional material showed greater than 90% eosinophils.
DESCRIPTION
A common, benign, transient, pustular eruption seen in the newborn period.
HISTORY
• Occurs more commonly in healthy term infants than in premature and low birth weight infants. • Cause unknown. • Rash resolves within 3 weeks of life without any adverse sequelae.
PHYSICAL FINDINGS
• Lesions appear as blotchy macules that develop into superficial pink papules and pustules, taking on a flea-bitten appearance. • Macules can coalesce to form large pink patches studded with only a few to hundreds of pustules. • Can occur anywhere on the skin, but face, arms, buttocks, and torso most frequently involved. Palms and soles rarely affected. • Overall, erythema toxicum neonatorum can wax and wane, with individual lesions appearing to occur in crops. • Individual lesions can disappear in hours or last for up to 2 weeks.
TREATMENT
• No treatment required. • Parents should be reassured.
Figure 1, 2 and 3 from Eichenfield LF, Frieden IJ, Esterly NB. Textbook of Neonatal Dermatology. Philadelphia: Saunders; 2001.
Figure 4 from Bolognia JL, Jorizzo JL, Rapini RP, eds. Dermatology. London: Mosby; 2003.
