Newborn Skin

Michael Traister, MD
 CASE:
• A healthy newborn is examined.
Diagnosis: Cutis marmorata
•Normal reticulated, bluish mottling of the skin
•No medical significance
 CASE:
• A three-day old girl is examined.
• The mother complains of a vaginal
discharge.
Diagnosis: Physiologic vaginal
discharge
•Normal finding
 CASE:
• A two-day old infant is examined.
• A rash is found on the face.
Diagnosis: Forceps Mark
 CASE:
• A one-month- old infant is
examined.
• He has a history of a forceps use
during a traumatic delivery.
• The mother has found “lumps” on
the cheeks and body.
Diagnosis: Subcutaneous fat necrosis
 CASE:
• A newborn is examined.
Diagnosis: Sebaceus gland
hypertrophy
•Normal finding
•Multiple yellow or flesh-colored tiny papules on the
nose, cheeks and upper lips of full term infants
•Caused by maternal androgenic stimulation
•Resolve in a few weeks.
 CASE:
• A newborn is examined.
Diagnosis: Milia
•Retention cyst of keratin and sebaceus material
•Seen in 40-50% of newborns
•One-to-two millimeter white papules on the face of
full term infants
•Resolve in a few weeks.
 CASE:
• A newborn is examined.
Diagnosis: Epstein’s pearl
 CASE:
• A one-month-old is examined.
• Multiple white “nodules’’ are seen
on the gums.
Diagnosis: Bohn’s nodules
•Normal finding
•Discrete 2-3 mm round pearly white elevations a the
gum margins
•Histologically the oral counterpart of facial milia
•Resolve in a few weeks.
 CASE:
• A newborn is examined.
• “Blue” hand and feet are noted.
Diagnosis: Acrocyanosis
•Normal finding
 CASE:
• A newborn is examined.
Diagnosis: Mongolian spots
•Normal finding
•Should not be confused with bruises
 CASE:
• A three-day-old is examined.
Diagnosis: Erythema toxicum
•Benign, self-limiting
•Accumulation of eosinophils
•Should not be confused with pustulosis
 CASE:
• The nurse in the newborn nursery
calls you to look at a diaper of a
two-day-old breast fed baby.
Diagnosis: Urate crystals
 CASE:
• A five-day-old girl is examined.
• The mother complains of blood in
the diaper.
Diagnosis: Pseudo-menses
 CASE:
• A three-day-old is examined.
Diagnosis: Cephalohematoma
 CASE:
• A one-month-old is examined.
• A hard lump is felt on the right side
of the head.
Diagnosis: Calcified Cephalohematoma
 CASE:
• A newborn is examined.
• Crepitus is felt near the right
shoulder.
Diagnosis: Clavicular fracture
 CASE:
• A one-month-old is examined.
• A hard lump is felt near the right
shoulder.
Diagnosis: Calcified clavicular fracture
 CASE:
• A newborn is examined.
Diagnosis: Umbilical hernia
 CASE:
• A two-week-old is examined.
Diagnosis: Omphalitis
 CASE:
• A two-week-old is examined.
Diagnosis: Umbilical granuloma
 CASE:
• A newborn is examined.
Diagnosis: Nevus flammeus (or nevus
simplex, or salmon patch)
 CASE:
• A newborn is examined.
Diagnosis: Sturge-Weber syndrome
 CASE:
• A two-week-old presents with
bilateral swollen breasts.
Diagnosis: Normal breast engorgement
 CASE:
• A two-week-old presents with one
swollen, red breast.
Diagnosis: Neonatal mastitis
 CASE:
• A two-month-old is examined.
Diagnosis: Thrush
 CASE:
• A one-month-old is examined.
• A rash on the face is noted.
Diagnosis: Neonatal acne
•Transplacental maternal androgenic stimulation
•No treatment necessary
 CASE:
• A one-month-old breast fed baby is
examined.
• The mother complains of a blister
on the baby’s lip.
Diagnosis: Sucking blister
 CASE:
• A two-month-old baby is examined.
• The mother complains of scales on
the top of the infant’s head.
Diagnosis: Seborrheic dermatitis
•Self-limiting condition of the scalp, face,trunk and
intertriginous areas
•.characterized by greasy scaling with patchy redness
•Caused by transplacental androgenic stimulation
 CASE:
• A one-month-old baby is examined.
• A rash is noted on the neck.
Diagnosis: Miliaria
•Sweat retention due to keratin plugging of the
eccrine ducts
•Miliaria rubra: discrete erythematous papules
•Miliaria crystallina: clear pinpoint vesicles
•Miliaria pustulosa: cloudy pinpoint vesicles
 CASE:
• A four-day-old baby is examined.
Day one of life
Day two of life
Day four of life
Diagnosis: Transient neonatal
pustular melanosis
•Seen in 4% of black and 0.2% of white newborns
•Vesico-pustular lesions that rupture and leave a
collarette of scale around a pin-head size
hyperpigmented macule
•Fade in a few weeks
 CASE:
• A three-month-old is examined.
Diagnosis: Telogen effluvium
 CASE:
• A three-month-old presents with a
diaper rash.
Diagnosis: Diaper dermatitis - monilial
 CASE:
• A three-month-old presents with a
diaper rash.
Diagnosis: Diaper dermatitis - contact
 CASE:
• A three-month-old presents with a
diaper rash.
Diagnosis: Diaper dermatitis - psoriasis
 CASE:
• A five-day-old is examined.
• The mother asks about “red eyes.”
Diagnosis: Subconjunctival hemorrhage
 CASE:
• A three-month-old presents with a
diaper rash.
Diagnosis: Diaper dermatitis – bullous
impetigo leading to staph
scaled skin syndrome
 CASE:
• A one-year-old is examined.
Diagnosis: Strawberry hemangioma
 CASE:
• A nine-month-old black infant
presents with recurrent pruritic
papules on the feet.
Diagnosis: Acropustulosis of infancy
 CASE:
• A newborn is examined.
• A lesion is noted on the vertex
Diagnosis: Cutis aplasia
 CASE:
• A newborn is examined.
Diagnosis: Natal teeth
 CASE:
• A newborn is examined.
• A lesion is noted on the scalp.
Diagnosis: Nevus sebaceus
 CASE:
• A newborn is examined.
Diagnosis: Club feet – equinovarus
 CASE:
• A newborn is examined.
Diagnosis: Congenital pigmented nevus
 CASE:
• A newborn is examined.
Diagnosis: Giant hairy nevus
 CASE:
• A newborn is examined.
Diagnosis: Retinoblastoma
 CASE:
• A newborn is examined.
Diagnosis: Congenital glaucoma
 CASE:
• A newborn is examined.
Diagnosis: Cataracts (congenital rubella syndrome)
 CASE:
• A two-month-old is examined.
• The mother complains that the
infant looks only to the right side.
Diagnosis: Positional plagiocephaly
 CASE:
• A two-month-old is examined.
• The mother complains that the
infant looks only to the right side.
Diagnosis: Congenital torticollis
 CASE:
• A newborn is examined.
Diagnosis: Ankyloglossia
 CASE:
• A newborn is examined.
Diagnosis: Epulis
 CASE:
• A newborn is examined.
Diagnosis: Cystic hygroma
 CASE:
• A newborn is examined.
Diagnosis: Lipomeningocele
 CASE:
• A newborn is examined.
Diagnosis: Diastematomyelia
 CASE:
• A newborn is examined.
Diagnosis: Polydactyly
 CASE:
• A newborn is examined.
Diagnosis: Pre-auricular ear pit
 CASE:
• A newborn is examined.
Diagnosis: Simian crease
 CASE:
• A newborn is examined.
Not crying
Crying
Diagnosis: Asymmetric crying facies
 CASE:
• A newborn is examined.
Diagnosis: Accessory nipple
 CASE:
• A newborn is examined.
Diagnosis: Pre-auricular skin tags
 CASE:
• A three-month-old is examined.
• The mother claims that “crystals”
are coming from the baby’s urine.
Diagnosis: Diaper crystals
 ‫ال تنسونا من صالح دعاؤكم‬

‫د‪ /‬صبري شعبان عصفور‬