Differential Diagnoses
Congenital cutaneous candidiasis
Miliaria rubra
Neonatal acne
Neonatal herpes simplex
Transient neonatal pustular melanosis
Diagnosis
Erythema toxicum neonatorum
Learnings
Erythema toxicum neonatorum is a common benign skin eruption of uncertain cause that occurs in newborns. It is seen in full-term infants and is rare in the premature. The rash most often develops between the second and fourth day of life and resolves within hours to days.
Erythema toxicum very rarely presents at birth or affects the palms and soles, distinguishing it from congenital candidiasis and transient neonatal pustular melanosis, in which this is characteristic.
Reassure the parent or caregiver that this common rash is transient and benign. No therapy is needed, because the condition is self-limiting.
What to Look For
The characteristic lesion is a 1- to 2-mm pale-yellow to yellow papule or pustule within a large (>1 cm) inflammatory wheal. Early on, however, the rash may consist of only blotchy, irregular erythematous macules. Any skin surface may be involved, but usually the palms and soles are spared.
Acknowledgment: Image courtesy of Logical Images, Inc. (www.VisualDx.com/JUCM)