Toxic erythema of the newborn

| The skin of the newborn is special, fragile and with a particular anatomy and physiology. Many neonates have skin lesions, such as erythema toxicity, which in most cases do not require treatment.

Toxic erythema is the acne more common in the newborn and affects approximately between 20 and 70% of those born to term, being very rare in the premature. Its name tends to scare parents, but it is inaccurate, as no evidence has been found to confirm this toxic nature. Is a benign inflammatory rash It was described in 1826. Since its description it has received different names: toxoallergic rash, neonatal urticaria or "flea bite dermatitis."

Symptoms

Lesions appear at 24-72 hours of life (some case from two or three weeks after birth). Its symptoms are the appearance of multiple small papules 1 to 3 cm in diameter. Its most frequent location is the face, trunk and extremities. It does not affect the palms of the hands or the soles of the feet. The papule evolves to pustule with a very erythematous or reddish halo. When the lesions are very abundant they can join and form plates of several centimeters. Each of the injuries persists for only a few hours and then disappears. The rash as a whole can last about 7-10 days, but in some cases it can persist for weeks. Toxic erythema presents Koebner phenomenon, that is, we can observe the appearance of injuries in areas exposed to friction and small trauma, such as. Cases of recurrences after the eruption has disappeared have been described in the medical literature.

Treatment

Does not require treatmentIt does not affect the general or health status of the newborn, so it is not treated, and it resolves on its own in a few days or weeks. The only precaution is that one must be performed and we must differentiate it from the following entities that do require treatment:

• Folliculitis: is a bacterial infection by Staphyloccocus aureus or Haemophilus influenzae that must be treated with antibiotics
• Disseminated herpetic infection. It is a viral infection with serious repercussions on the health status of the newborn that requires admission and treatment.

Dra. Esther Martínez García Pediatric Specialist