II. Definition

  1. Most common pustular dermatitis in newborns

III. Epidemiology

  1. Incidence: 30-70% of all infants
  2. More common in term infants (birth weight >2500 grams)

IV. Symptoms

  1. Newborn Rash with flea-bitten appearance
  2. Occurs 24 hours to 2 weeks after birth
  3. Lesions fade in 1 week (may recur in first few weeks of life)

V. Signs

  1. Characteristics: Follicular, yellowish-hued, papulovesicular lesions
    1. Starts as Macule or Papule
    2. Develops Pustules later
    3. Lesions sorrounded by irregular erythema
  2. Size: lesions are 1 to 3 mm in diameter
  3. Distribution
    1. Involved areas: Face, trunk, and proximal arms, and legs
    2. Spared areas: palms and soles
  4. No associated organ involvement
    1. Contrast with Neonatal HSV (e.g. Hepatomegaly)

VI. Labs

  1. Vesicles contain Eosinophils on Gram Stain or wright stain
  2. Negative culture
  3. Complete Blood Count
    1. Differential with increased Eosinophils

VII. Differential Diagnosis

VIII. Management

  1. None needed for this benign dermatitis
  2. Resolves spontaneously

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