Newborns, skin changes P83.9

The skin of the newborn baby is often different from that of the older child. The transition from the aqueous intrauterine environment to the postnatal "air environment" requires anatomical and functional adaptation processes that take several months. These manifest themselves as "transitory skin symptoms" without any major pathological value. They subside within a few days without treatment.

The stratum corneum in premature babies is still immature, recognizable by an increased transepidermal water loss and an increased gas exchange for carbon dioxide and oxygen. There is an immaturity of the eccrine sweat glands with deficient function (danger of overheating in incubators).

• Transient changes in newborns:
  • Vernix caseosa
  • Acrocyanosis
  • Harlequin discoloration
  • Erythema (toxicum) neonatorum
  • Transitory neonatal pustular melanosis (pustulose)
  • Sebaceous gland hyperplasia
  • Milia
  • Miliaria
  • postnatal desquamation
  • Suction bubbles, localized
  • Mongolian spot
  • Epstein-Pearls (see below milia of the infant)
  • Pityrosporum folliculitis of the infant (neonatal zephale pustulose)
  • Cutis marmorata.
• Diseases of the fatty tissue:
  • Fatty tissue necrosis, subcutaneous of the newborn
  • Scleroedema (Sclerema) neonatorum
  • Cold paniculitis.
• Vesiculo-pustular diseases (non-infectious/infectious):
  • Non-infectious vesiculo-pustular diseases:
    • Acropustulose, infantile
    • Transient neonatal pustulosis (pustular melanosis)
    • Eosinophil pustular folliculitis
    • Transient bullous dermolysis of the newborn
    • Pemphigoid gestationis (transfer of AK to the child)
    • dermatitis herpetiformis
    • incontinentia pigmenti
    • Langerhans cell histiocytosis
    • Bullous mastocytosis
    • Diaper dermatitis
    • Granuloma gluteale infantum.
  • Infectious vesiculo-pustular diseases:
    • contagious impetigo
    • Neonatal toxic-shock-like exanthematous disease
    • Pityrosporum folliculitis of the infant (neonatal zephale pustulose)
    • Congenital and neonatal candidosis
    • Primary cutaneous neonatal aspergillosis
    • neonatal scabies
    • Herpes simplex neonatorum
    • Congenital and neonatal varicella syndrome.
• maculopapular exanthema:
  • Congenital infections with exanthematic HV (the classical congenital infections were given the acronym STORCH):
    • Syphilis connata
    • Toxoplasmosis
    • "others": listeriosis, enteroviruses; Epstein-Barr virus and others
    • rubella, connatal
    • Cytomegalovirus infection
    • Herpes virus.
  • Neonatal lupus erythematosus
  • Autoinflammatory syndromes:
    • CINCA syndrome
    • Muckle-Wells Syndrome
    • Familial cold urticaria
  • Acrodermatitis enteropathica.
• Figured erythema:
  • Infantile infantile anal erythema
  • Familial anular erythema
• Neonatal erythroderma.

1. Hoeger PH et al (2000) Neonatal onset of rash in Still`s diesease. J Pediatr 137: 128-131
2. Rapelanoro R et al (1996) Neonatal malazessia furfur pustulosis. Arch Dermatol 132: 190-193
3. Siegfried EC (1998) Neonatal skin and skin care. Dermatol Clin 16: 437-446