Get started
Work

Newborn with a pustular rash

Year: 2024
Type: article
Study design: Case Report
Abstract: At presentation, differential diagnoses of cutaneous infection caused by bacteria (staphylococci or streptococci), viruses (herpes simplex and varicella) and benign neonatal pustular dermatoses including a precocious form of erythema toxicum neonatarum (ETN) and transient neonatal pustular melanosis (TNPM) were considered. Bacterial and viral swabs of the pustules, full blood examination (FBE), C reactive protein (CRP) and blood culture were obtained and the baby was started on intravenous flucloxacillin. Swabs and blood cultures resulted negative and inflammatory markers were not elevated. Rash started to improve on day 3 and resolved in a week with no residual pigmentation. A diagnosis of a precocious form of ETN was made. The two benign pustular eruptions considered in the baby were ETN and TNPM. The more common ETN frequently start as an erythematous rash, 24–72 h after birth, evolve into white papules and rarely progress to pustules. The pustules in ETN have an erythematous rim and resolves in days to weeks with no residual pigmentation.1 TNPM is characterised by pustules with a non-erythematous base which rupture and form crusts that leave residual pigmented macules.2 The pustules in our baby were surrounded by an erythematous ring and resolved spontaneously in a week without residual pigmentation, making ETN the most likely diagnosis. Precocious forms of ETN are described.3 A newborn with a pustular rash is a concern for parents and health professionals. Our case highlights the following: (i) at presentation, a wide range of differential diagnoses need to be considered; (ii) differentiating infectious from non-infectious aetiology is difficult, particularly for the regional paediatrician with no ready access to a dermatologist; and (iii) a newborn with a pustular rash may need to be managed as for an infection pending results of investigations. Consent was taken from mother to publish the photographs.
DOI: 10.1111/jpc.1_16413
Language: English
Open Access status: bronze
OpenAlex ID: W4397042403
FWCI:
Cites: 3
Cited by:
Related to: 10