Common Skin Conditions in Children: Neonatal Skin Lesions

Abstract

Skin findings during the initial month of life are ubiquitous. One study estimated that more than 95% of newborns have cutaneous findings, which often are distressing to parents but frequently are benign and self-limited. Among them are milia, cutis marmorata, congenital dermal melanocytosis, and the benign neonatal pustular eruptions (eg, benign cephalic pustulosis, erythema toxicum neonatorum, transient neonatal pustular melanosis). Clinicians need to recognize these benign skin conditions and differentiate them from more serious conditions, such as infectious pustular eruptions from bacterial, viral, and fungal causes, and inflammatory conditions, such as Langerhans cell histiocytosis. Notable bacterial pustular eruptions are bullous impetigo and congenital syphilis. Viral pustular dermatoses include neonatal herpes simplex virus infection and varicella zoster virus infection, which consists of congenital varicella syndrome, perinatal varicella, and infantile zoster. Fungal pustular eruptions include congenital and neonatal candidiasis. Seborrheic dermatitis is a self-limited condition that occurs with varying severity; symptomatic treatment is reserved for the more severe forms. Diaper dermatitis encompasses a broad clinical diagnosis, including allergic and irritant contact dermatitis, atopic dermatitis, infections, psoriasis, and other dermatologic conditions. Critical components of newborn skin care are immersion bathing, umbilical cord care, and use of emollients to augment skin barrier function.