PEDBASE.org - The Pediatric Database - Detailed information of ERYTHEMA TOXICUM NEONATORUM

ERYTHEMA TOXICUM NEONATORUM

DEFINITION:

A benign self-limited rash of unknown etiology presenting in the newborn period.

EPIDEMIOLOGY:

incidence: from 50-70% of full-term infants
age of onset:
- typically from 24-48 hours after birth
- eruptions can be delayed for days to weeks after birth (especially in premature infants)
risk factors:
- term infants
- M = F

PATHOGENESIS:

1. Background

unknown etiology
the lesions form in the epidermis and contain eosinophils which can be identified by Wright stain

CLINICAL FEATURES:

1. Skin Manifestations

1-3 mm papules or pustules on an erythematous (red) base which is usually 2-3 cm in diameter
lesions are firm and yellow-white in colour
rash is sparse to widespread and ranges from a few lesions to hundreds
lesions tend to cluster on the face, trunk, buttocks, and proximal extremities but can occur anywhere although the palms, soles, and perioral regions are usually spared

INVESTIGATIONS:

1. Pathology

the intralesional contents show collections of eosinophils with no organisms seen on culture

2. CBC

eosinophilia in up to 20% of patients

MANAGEMENT:

1. Supportive

no treatment is required
the rash is self-limiting with spontaneous resolution within 5-7 days

ADDITIONAL REFERENCES:

1. Arndt, K.A., J.K. Robinson, P.E. LeBoit, B.V. Wintroub, Cutaneous Medicine and Surgery. Vol. 2. p. 1894-5, (1996).

2. Rudolph, A.M., Rudolph's Pediatrics. 19th Edition. p. 879-880, (1991).

3. Zetelli, B.J. and H.W. Davis, Atlas of Pediatric Physical Diagnosis. 3rd Edition. p. 246, (1997).

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