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The Lactation College on Substack
Pediatric Pearls: Infant's Skin Part 2 - My Big 4

Pediatric Pearls: Infant's Skin Part 2 - My Big 4

May 16, 2023

Barbara L. Philipp, MD's avatar
Barbara L. Philipp, MD
May 16, 2023
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The Lactation College on Substack
The Lactation College on Substack
Pediatric Pearls: Infant's Skin Part 2 - My Big 4
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First, a review of terms used commonly in the world of dermatology as understood by me, someone who is not a dermatologist.

  • Macule - a flat lesion that has a different color than normal skin

  • Papule - a raised lesion

  • Pustule - a raised lesion that contains pus

  • Vesicle - a raised lesion that is fluid filled

Working as a Newborn Medicine Hospitalist - if I had to pick the four rashes I see the most - they would be:

  • erythema toxicum neonatorum

  • transient neonatal pustular melanosis

  • slate gray

  • nevus simplex

Erythema toxicum neonatorum

Erythema toxicum (“e tox”) is the most common pustular rash, occurring in up to 70% of full-term infants. Sometimes called “allergy to life”, the rash is usually not seen at birth but shows up on the 2nd to 3rd day of life.

The rash evolves in several stages.

  • It starts with a 2-mm to 3-mm reddish blotchy macule or papule (many text books describe this as a “flea-bitten” appearance)

Next comes the red papule with a firm whitish nodule (bump) in the middle.

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