Erythema toxicum neonatorum usually appears after the age of 3 days and within the first two weeks of life, but they may rarely occur slightly before or later [1] [2]. Manifestations consist of macular erythema, papules, pustules, and vesicles. Particular skin changes resolve by themselves in several minutes to hours, leaving no sequelae [3]. As old lesions disappear, new ones appear and the total duration of erythema toxicum neonatorum is from five days to two weeks. The patient is not febrile during this period and signs such as lethargy or irritability are absent. Mucosal involvement is almost always absent and, when present, the physician should consider herpes simplex infection or candidiasis, especially if present in the mother [4]. Once the disease is resolved, recurrence is infrequent but mild episodes are possible before the sixth week of life.

The skin lesions with an erythematous halo spread centripetally. They are usually absent in the palmar and plantar areas while the lesions are most often found on the face [5], trunk, proximal limbs, and buttocks but may even involve the genitalia [6]. Their size is variable, they are blanchable, and have irregular margins.

Caucasian infants born after a long labor by vaginal delivery, who have a higher birth weight and are born at a higher gestational age are more likely to develop erythema toxicum neonatorum and manifestations tend to have a longer duration. Newborns that receive infant formulas, those born in the summer or autumn whose mothers are younger than 30 years are also at a higher risk [7].

• Cough

  BIBLIOGRAPHY 26 9Infectious Diseases 28 DIPHTHERIA 33 PERTUSSIS WHOOPING COUGH 36 INFLUENZA 40 RUBELLA GERMAN MEASLES 44 RUBEOLA RED MEASLES 47 ROSEOLA EXANTHEM SUBITUM 49 FIFTH DISEASE ERYTHEMA INFECTIOSUMEI 51 VARICELLAZOSTER VIRUS VZV CHICKENPOX 54 [books.google.de]

  A person should contact a doctor if a newborn: has a rash and high temperature has a rash and a cough or cold symptoms has a rash with swollen neck glands is drowsy or hard to wake has a case of cradle cap, or newborn dandruff, which worsens over time [medicalnewstoday.com]

  Cold symptoms, such as a cough or runny nose. Excessive tiredness (lethargy). Fever. Rash that bleeds. Rash that lasts longer than two weeks. A note from Cleveland Clinic Erythema toxicum neonatorum is a skin condition that affects newborns. [my.clevelandclinic.org]

  Cancer ( +14 ) Common Liver Problem ( +3 ) Nerve ( +8 ) Skin ( +23 ) Thalassemia Hypotension Measles Mumps Obesity in Adult Parasitic Infections Microbiology Bakteria vs Virus Laboratory Diagnosis Vaccination / Immunization Signs & Symptoms Fever Cough [myhealth.gov.my]

• Dental Caries

  Problems Orbital Swellings And Oral Health Facial Swelling Tooth Discolouration Wisdom Tooth Crowded Teeth Deranged Bite Oral Infections Oral Cancer Root Caries Early Childhood Caries Dental Caries Tongue Abnormalities Dental Hard Tissue Anomalies In [myhealth.gov.my]

• Skin Lesion

  The clinical lesions referred to as erythema toxicum neonatorum are known to localize at pressure sites. The skin lesions correct as maternal and placental hormone influence weakens. The entity occurs in 31 to 72% of white infants. [ncbi.nlm.nih.gov]

  However, recent studies have failed to prove the presence of maternal cells in skin lesions. [momjunction.com]

  Increased expression of HMGB-1 in the skin lesions of erythema toxicum. Pediatr Dermatol. 2007 Sep-Oct. 24(5):474-82. [Medline]. Marchini G, Lindow S, Brismar H, et al. [emedicine.medscape.com]

  The skin lesions with an erythematous halo spread centripetally. They are usually absent in the palmar and plantar areas while the lesions are most often found on the face, trunk, proximal limbs, and buttocks but may even involve the genitalia. [symptoma.com]

• Skin Disease

  Benign skin disease with pustules in the newborn. An Bras Dermatol. 2016; 91 (2): 124-134. doi: 10.1590/abd1806-4841.20164285. Morgan AJ, Steen CJ, Schwartz RA, Janniger CK. Erythema toxicum neonatorum revisited. Cutis. 2009;83 (1):13-16. [medigraphic.com]

  Fölster-Holst R, Höger P (2010) Pustular skin diseases of the newborn. JDDG 7: 569-579 Hansen LP et al (1985) Erythema toxicum neonatorum with pustulation versus transient neonatal pustular melanosis. [altmeyers.org]

  Based on Lever's Histopathology of the Skin, Ninth Edition, this full-color atlas presents an algorithmic pattern recognition approach to differential diagnosis of skin diseases. [books.google.de]

  While the causes of ETN are unknown, the disease occurs as a small yellow-white bump on the skin, which looks like small blisters or fluid-filled bags on the newborn’s skin. [asterhospitals.in]

• Urticaria

  TYPES OF URTICARIA There are different types of urticaria : Cholenergic urticaria Physical urticaria. Herido-familial urticaria Idiopathic urticaria. [drmhijazy.com]

  Urticaria neonatorum--an earliest marker of atopy. Indian J Med Res. 1980 Feb. 71:273-7. [Medline]. Monteagudo B, Labandeira J, Cabanillas M, Acevedo A, Toribio J. [emedicine.medscape.com]

  Synonym(s) Erythema neonatorum allergicum; Erythema toxic of newborns; Erythema toxicum neonatorum; Neonatal erythema; Newborn erythema; Newborn exanthema; Toxic erythema of newborns; toxic erythema of the newborn; Toxic erythema of the newborn; Urticaria [altmeyers.org]

  Last reviewed 01/2018 Papular mastocytosis/erythema toxicum/urticaria pigmentosa This is believed to be an eruption due to a focal aggregation of mast cells in the dermis. [gpnotebook.com]

  Subscribe Log In More Log in using your username and password Basket Search More Close More Main menu Subscribe Log in More Log in using your username and password BMJ Journals Urticaria Neonatorum (Erythema Toxicum Neonatorum) Free Statistics from Altmetric.com [adc.bmj.com]

• Acne Vulgaris

  Acne neonatorum is another condition that is due to maternal hormone stimulation. It resembles acne vulgaris seen in adolescents (1). Neonatal acne presents with erythematous papules and pustules on the face. [hawaii.edu]

  OF THE NEWBORN (ACNE NEONATORUM see CEPHALIC PUSTULOSIS) ACNE VULGARIS ACRAL LICK DERMATITIS (see ATOPIC DERMATITIS) ACROMEGALOGIGANTISM ADENOID HYPERTROPHY ALBINISM ALOPECIA ALOPECIA, AREATA ALOPECIA DUE TO FRICTION ALOPECIA TOTALIS AND ALOPECIA UNIVERSALIS [euro-libris.ro]

• Freckles

  SPOT, MELANOCYTIC NEVUS, NEVOCYTIC NEVUS) BECKER’S NEVUS (BECKER’S MELANOSIS) FRECKLES LINEAR SEBACEOUS NEVUS NEVUS, INTRADERMAL NEVUS OF OTA (NEVUS FUSCOCERULEUS OPHTHALMOMAXILLARIS, OCULODERMAL MELANOSIS) MOLLUSCUM CONTAGIOSUM MONGOLIAN SPOTS (CONGENITAL [euro-libris.ro]

• Fussiness

  When to call the doctor for newborn rash Call your doctor if your baby has additional symptoms, like being extra fussy, not feeding well, or has a fever. [babycenter.com]

  Call your doctor if your baby has a rash and is also fussy, not feeding well, or has a fever. Date reviewed: September 2016 [kidshealth.org]

  Your baby seems floppy, fussy, or very drowsy. Reviewed by: Mary L. Gavin, MD Date Reviewed: Jan 1, 2022 [akronchildrens.org]

  Your baby seems floppy, fussy, or very drowsy. related articles want to learn more? thank an awesome doctor this Doctor's Day! [childrensdayton.org]

• Fear

  Despite the fears of the parents of the infant affected, the newborn is usually not sick even when the rashes appear to be extensive. Pathophysiology Activation of the immune system has been implicated as a potential cause of ETN. [news-medical.net]

  (JE) – TA Chikungunya Tuberculosis (TB) HIV / AIDS Severe Acute Respiratory Syndrome (SARS) Rabies (Penyakit Anjing Gila) Difteria Hepatitis B Influenza Pneumococcal Diseases Meningococcal Meningitis Tetanus Poliomyelitis Deep Vein Thrombosis (DVT) Fear [myhealth.gov.my]

• Irritability

  Definition (NCI) An inflammatory skin condition in the diaper area that may be caused by irritation of infection. [fpnotebook.com]

  Signs of systemic toxicity, including hypothermia or hyperthermia, lethargy, and irritability, are not associated with erythema toxicum neonatorum. [dermaamin.com]

  But if the baby has a fever, the rash is really red, it spreads across the baby’s body, or your baby is irritable or not acting like themselves, it’s time to go see your doctor. [todaysparent.com]

  The patient is not febrile during this period and signs such as lethargy or irritability are absent. [symptoma.com]

  In the pediatric population, irritant dermatitis is more commonly seen than allergic dermatitis. Irritant dermatitis is an inflammation of the skin caused by exposure to irritants such as soaps, saliva, citrus juice, bubble baths, or detergents (1). [hawaii.edu]

• Agitation

  C Calcifiere în craniu - on-line - doar Candidoză ( CUTANAT ) Candidoza, orale (vezi afte) Cataracta, CONGENITALĂ celulita cefalhematom Pustuloză cefalic, benigne ( acnee nou-născut ) șalazion POX pui ( vezi varicela ) ABUZ ( TRAUMA nonaccidental ) AGITATE [euro-libris.ro]

Clinical examination and attentive history inquiry are key tools for erythema toxicum neonatorum diagnosis and further investigations are usually unnecessary. A complete blood count may reveal increased eosinophil numbers. The histological evaluation of intralesional content shows the presence of eosinophils and neutrophils [4] [8]. If eosinophils are absent or a systemic disease is suspected, bacterial, viral, and fungal cultures are required. A potassium hydroxide preparation may confirm or exclude candidiasis. If cultures are proven negative and doubt still persists, a skin biopsy should be performed. In the case of erythema toxicum neonatorum, this method will highlight the presence of dermal edema and perivascular inflammatory infiltrate. The root sheath of the hair follicle may also be invaded by eosinophils while pustules are filled with the eosinophil-rich material [9]. In a severely ill child, blood cultures are indicated in order to exclude sepsis. Herpes virus infection can also be ruled out using fluorescent antibody testing or a Tzanck preparation.

• Staphylococcus Aureus

  It is important to differentiate toxic erythema from septic pustules, especially those due to Staphylococcus aureus. [gpnotebook.com]

  An epidemic of bullous impetigo in a newborn nursery due to Staphylococcus aureus: Epidemiology and control measures. Alsaka Med 1986;28:99-103. 39. Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ, et al. [e-ijd.org]

  View/Print Table Table 1 Infectious Causes of Vesicles or Pustules in the Newborn Class Cause Distinguishing features Bacterial Group A or B Streptococcus Listeria monocytogenes Pseudomonas aeruginosa Staphylococcus aureus Other gram-negative organisms [aafp.org]

  Bacteria most commonly isolated included CoNS (84%), Staphylococcus aureus (25%), Enterococcus species (19%), and α-Streptococcus (20%), with no difference noted between infants with (n = 33) and without rash (n = 36); for details see Figure 5. [nature.com]

• Listeria Monocytogenes

  View/Print Table Table 1 Infectious Causes of Vesicles or Pustules in the Newborn Class Cause Distinguishing features Bacterial Group A or B Streptococcus Listeria monocytogenes Pseudomonas aeruginosa Staphylococcus aureus Other gram-negative organisms [aafp.org]

  Influence of several antibiotics, singly and in combination, on the growth of Listeria monocytogenes. J Pediatr1972;80:667. 44. Darmstadt GL, Dinulos JG, Miller Z. [e-ijd.org]

  monocytogenes infection Pseudomonas aeruginosa infection Hemophilus influenzae infection Viral Herpes simplex virus infection (intrauterine, neonatal) Varicella (foetal varicella syndrome/congenital varicella/varicella embryopathy, neonatal varicella [ijdvl.com]

• Pseudomonas

  View/Print Table Table 1 Infectious Causes of Vesicles or Pustules in the Newborn Class Cause Distinguishing features Bacterial Group A or B Streptococcus Listeria monocytogenes Pseudomonas aeruginosa Staphylococcus aureus Other gram-negative organisms [aafp.org]

  Causes of pustular neonatal eruptions Cause Age Investigations Infectious Bacterial: Staphylococcus aureus, Streptococcus pyogenes, Hemophilus influenzae, Escherichia coli, Klebsiella pneumoniae, pseudomonas, listeria Swab MCS, systemic work-up Syphilis [racgp.org.au]

  […] neonatal pustular melanosis10 Miliaria/heat rash Neonatal cephalic pustulosis Neonatal acne Uncommon causes Acropustulosis of infancy Eosinophilic pustular folliculitis Infections Bacterial Impetigo Congenital syphilis Listeria monocytogenes infection Pseudomonas [ijdvl.com]

• Sarcoptes Scabiei

  scabiei, Scabies, Neonatal scabies, Erythema toxicum neonatorum, Transient pustular melanosis of infancy, Infantile acropustulosis A 3-month-old male infant was evaluated for the persistence of erythema toxicum neonatorum. [medicoebambino.com]

  Scabies is caused by the female Sarcoptes scabiei mite. A papular and vesicular rash is seen as a result of the mite burrowing into the stratum corneum. The mites burrow approximately 2mm (1). [hawaii.edu]

No treatment is needed. Erythema toxicum usually goes away on its own within a couple of weeks, with all symptoms gone by the time the baby is 1 to 4 months old. Don't try to pop any of the bumps or use ointments or baby oil on them. [babycenter.com]

Erythema toxicum neonatorum resolves spontaneously without treatment. [ijdvl.com]

Treatment The large red splotches usually disappear without any treatment or changes in skin care. Outlook (Prognosis) The rash usually clears within 2 weeks. It is often completely gone by age 4 months. [limamemorial.org]

ETN doesn’t require treatment. No changes in your baby’s skin care routine are necessary. Outlook for ETN Many harmless skin conditions can affect your newborn baby, including ETN. [healthline.com]

ETN doesn’t require treatment. No changes in your baby’s skin care routine are necessary. Outlook for ETN Many harmless skin conditions can affect your newborn baby, including ETN. [ishonest.com]

Prognosis The prognosis is excellent. The lesions typically resolve within 2 weeks, and no cutaneous or systemic sequelae are generally observed. This is a benign, asymptomatic, self-limited skin condition with no known sequelae. [emedicine.medscape.com]

Prognosis The prognosis is excellent with lesions resolving within 7-14 days. There are no residual sequelae. [ncbi.nlm.nih.gov]

Expectations (prognosis) The rash usually clears within 2 weeks. It is usually completely gone by age 4 months. Calling your health care provider Discuss the condition with your health care provider during a routine examination if you are concerned. [indiatoday.in]

Its etiology still remains obscure: some reaction of the skin of the newborn in adapting to its new environment is the favorite hypothesis to date. [ncbi.nlm.nih.gov]

Etiology of toxic erythema. Erythema toxicum neonatorum. Am J Dis Child. 1963 Sep. 106:306-9. [Medline]. Bassukas ID. [emedicine.com]

Currently, there are no clear epidemiological data, reporting incidences from 3.7% to 72%, so we aimed to identify the epidemiological characteristics of toxic erythema in newborns, treated at Hospital Angeles Pedregal. [medigraphic.com]

Epidemiologic study of the predisposing factors in erythema toxicum neonatorum. Dermatology. 2005. 210(4):269-72. [Medline]. Monteagudo B, Labandeira J, Cabanillas M, Acevedo A, Toribio J. [emedicine.medscape.com]

[…] erythema toxicum neonatorum Member Rated 0 Patient case no. 638 Date added 01 January 1990 Patient details Age Baby / infant Localisation Head / face / forehead Primary Lesions Papule / erythematous Pustule / follicular Erythema Pathophysiology tumors [dermquest.com]

Pathophysiology The underlying mechanism of erythema toxicum neonatorum (ETN) is unknown, although various hypotheses have been described. [5] Etiology The underlying pathophysiology is uncertain. [emedicine.medscape.com]

Pathophysiology The condition has been known throughout the ages and was described by ancient Mesopotamian physicians [ 2 ]. [patient.info]

Prevention How can I prevent erythema toxicum neonatorum? There’s no way to prevent erythema toxicum neonatorum. The good news is that the condition doesn’t cause any harm to your baby. Usually, your baby’s skin heals within two weeks. [my.clevelandclinic.org]

Children and newborn skin care and prevention. An Bras Dermatol. 2011; 86 (1): 102-110. doi: 10.1590/s0365-05962011000100014. Lund C, Kuller J, Lane A, Lott JW, Raines DA. Neonatal skin care: the scientific basis for practice. [medigraphic.com]

Photo credit: Centers for Disease Control and Prevention (CDC) Signs and symptoms of newborn rash It looks like small white or yellow "pimples" sometimes surrounded by red skin. [babycenter.com]

In fact a prompt diagnosis is crucial to prevent the superinfection of the patient lesions, as well as epidemic outbreaks. Vuoi citare questo contributo? L'accesso è riservato agli abbonati alla rivista che si siano registrati. [medicoebambino.com]

1. Kanada KN, Merin MR, Munden A, et al. A Prospective Study of Cutaneous Findings in Newborns in the United States: Correlation with Race, Ethnicity, and Gestational Status Using Updated Classification and Nomenclature. J Pediatr.2012;161(2):240-245
2. Reginatto FP, Villa DD, Cestari TF. Benign skin disease with pustules in the newborn. An Bras Dermatol.2016;91(2):124-134.
3. Schwartz RA, Janniger CK. Erythema toxicum neonatorum. Cutis. 1996;58(2):153-155.
4. Monteagudo B, Labandeira J, Cabanillas M, et al. Prospective Study of Erythema Toxicum Neonatorum: Epidemiology and Predisposing Factors. Pediatr Dermatol. 2012;29(2):166-168.
5. Mahajan VK, Sharma NL. Erythema toxicum neonatorum. Indian Pediatr.2010;47(9):793.
6. Maffei FA, Michaels MG, Wald ER. An unusual presentation of erythema toxicum scrotal pustules present at birth. Arch Pediatr Adolesc Med. 1996;150(6):649-650.
7. Liu C, Feng J, Qu R, et al. Epidemiologic study of the predisposing factors in erythema toxicum neonatorum. Dermatology. 2005;210(4):269-272.
8. Van Praag MC, Van Rooij RW, Folkers E, et al. Diagnosis and treatment of pustular disorders in the neonate. Pediatr Dermatol. 1997;14(2):131-143.
9. Marchini G, Ulfgren AK, Lore K, et al. Erythema toxicum neonatorum: an immunohistochemical analysis. Pediatr Dermatol. 2001;18(3):177-187.