Erythema toxicum

Erythema toxicum: Description:An innocuous, self-limited rash of unknown cause that occurs in newborn infants. The condition is also sometimes called erythema toxicum neonatorum (ETN) or toxic erythema of the newborn.Erythema toxicum may appear in 50 percent or more of all normal newborn infants. It usually appears in term infants between the ages of 3 days and 2 weeks. Its cause is unknown. The condition may be present in the first few hours of life, generally appears after the first day, and may last for several days. The rash usually clears within 2 weeks. It is usually completely gone by age 4 months. Erythema toxicum neonatorum is a self-limited eruption that resolves spontaneously. There are no complications.ERYTHEMA TOXICUMErythema toxicum neonatorum occurs in one third to one half of full-term infants and in 5% of premature infants.Symptoms:The main symptom is a rash of small, yellow-to-white colored papules surrounded by red skin. There may be a few or several papules. They usually appear on the face and middle of the body, but may also be seen on the upper arms and thighs.The rash temporary appears for hours to days and then disappears.Causes and Risk factors:The cause of erythema toxicum neonatorum is unknown. Multiple theories have been proposed to explain this common disorder.Erythema toxicum neonatorum may be a response to microbes that have penetrated the hair follicle. This process may possibly be integral in developing the new immune system. No responsible exotoxin, allergen, component of sebum, or infectious agent has been linked credibly to erythema toxicum neonatorum.Other proposed theories include a transient adjustment reaction of the skin to mechanical or thermal stimulation or an acute graft-versus-host reaction induced by the maternal-fetal transfer of lymphocytes before or during delivery.Risk factors include birth in hot wet climates, being fed on a mixed diet or milk-powder substitute, and being born via vaginal delivery. A positive correlation has been recognized between the length of labor and both the incidence of erythema toxicum neonatorum and the duration of the cutaneous manifestations.Diagnosis:Examination by your health care provider during a routine well-baby exam is usually sufficient to make the diagnosis. No testing is usually needed.Erythema toxicum neonatorum (ETN) is diagnosed clinically based on history, physical examination, and peripheral smear of intralesional contents.On a CBC count, eosinophilia are noted in approximately 15% of patients as up to 18% of the total WBC count. Eosinophilia may be more pronounced when the eruption shows a marked pustular component.A Tzanck smear or Gram stain performed on intralesional contents is essential for diagnosis. Inflammatory cells are present, with greater than 90% eosinophils and variable numbers of neutrophils. A skin biopsy is diagnostic but rarely is required for diagnosis.Treatment:The large red splotches typically disappear without any treatment or changes in skin care.Medicine and medications:Erythema toxicum neonatorum is a benign self-limited disorder requiring no medications.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care. 

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