Definition

A skin condition causing rashes known as erythema toxicum neonatorum can develop on a newborn's skin. The Latin word "toxicum" signifies poisoning, while the word "erythema" refers to redness. The term "neonatorum" refers to the 28-day period following a baby's birth. Neonates are newborn infants under 28 days of age, they fall within this age range. Erythema toxicum neonatorum, however, is not a disorder that causes poisoning in infants. Another name for erythema toxicum neonatorum is urticaria neonatorum.

A common disease frequently observed in newborns is erythema toxicum neonatorum. While it is very uncommon in prematurely born babies (preterm), this condition is thought to afflict almost half of all full-term neonates (between 37 and 40 weeks of gestation). The rashes are characterized by pale yellow pimples papules and pustules surrounded by red skin, usually affects the baby's face or middle trunk, but it can also occur on the arms or thighs. Although it may manifest in the initial days following delivery, erythema toxicum neonatorum often develops 3 to 14 days after birth. Even in the absence of therapy, erythema toxicum neonatorum is not a serious condition that could go away on its own.

Causes

It is currently unknown what causes explicitly erythema toxicum neonatorum. Although pus-filled pustules can occasionally be seen on the skin, this disease is not caused by an infection. Several explanations have been proposed, one of which is that the baby's immune system may respond normally to this condition rather than an allergic reaction. Furthermore, whether the infant is formula-fed or breastfed has little bearing on the development of erythema toxicum neonatorum.

Another probable cause for erythematous toxicum neonatorum may be associated with the baby's skin's immature oil glands and fine hairs. When compared to adults, newborns typically have more fine hairs. Because places like the palms of hands and soles of feet lack fine hair, Erythema toxicum neonatorum is rarely encountered in these areas. Accumulations of inflammatory cells are also frequently observed in the fine hair, suggesting that erythema toxicum neonatorum may be a reaction to bacteria that have invaded the fine hair. This process is thought to have a significant role in the immune system development of a baby.

Risk factor

Erythema toxicum neonatorum is hypothesized to be more common in neonates due to several causes, including:

• Newborns from vaginal delivery
• Infants born in hot and humid weather
• Healthy full-term infants who are not admitted to the Neonatal Intensive Care Unit (NICU)
• Overweight newborns
• Infants born in the summer or fall
• Male infants

Symptoms

Rashes that resemble red patches on the skin are typically the symptom of erythema toxicum neonatorum. These rashes start on the face and can spread to the arms, legs, and trunk but do not affect the palms of the hands or the soles of the feet. In addition, raised-surfaced bumps (papules) frequently develop. Little bumps packed with fluid (vesicles) or pus (pustules) will occasionally appear.

The rash typically resembles small yellow or white "pimples" encircled by red lesions. The number and size of the developing rashes can vary; they typically range from 1 to 4 mm. The rash will seem pale and fade when gently pressed. The rash often appears two to five days after the baby is born but may emerge sooner.

Skin rashes are typically brief and may disappear in a few hours, but new ones will always develop elsewhere. The rash will usually go away in five to fourteen days. The newborn with erythema toxicum neonatorum will not exhibit any other symptoms and appear to be in good overall health.

Diagnosis

Medical Interview and Physical Examination

The baby's parents or babysitter will be the first people the doctor interviews to diagnose erythema toxicum neonatorum. The baby's symptoms, the duration of the symptoms, the location and extent of the skin rashes will all be questioned by the doctor. In addition, the doctor will search for risk factors that could be involved in developing erythema toxicum neonatorum. The doctor will then inspect the rashes' clinical appearance as part of a physical examination. The physician might also apply pressure to the rash and palpate the skin's surface where the rash is located.

Diagnostic Tests

Because erythema toxicum neonatorum has a fairly normal clinical presentation, the diagnosis can essentially be made based on the findings of medical interviews and physical examinations. However, additional diagnostic tests, like a Tzanck smear, may be performed if the doctor feels the child has another medical condition. In this procedure, a tiny scrape of skin or fluid from the nodule is taken, dripped with a special fluid, and the sample is viewed under a microscope.

A skin biopsy is another test that your doctor can suggest. In this procedure, a tiny sample of skin tissue is taken and sent to a lab for microscopic analysis.

Management

Typically, the rashes found in erythema toxicum neonatorum will last for a few days. Erythema toxicum neonatorum does not require special care because the rash will disappear in 5 to 14 days. Skin rashes won't leave scars or result in other harmful issues.

Complications

Erythema toxicum neonatorum is not a severe or serious condition. The baby's skin will revert to normal and the rashes will go away on its own. Furthermore, erythema toxicum neonatorum does not result in complications or other long-term issues.

Even though this condition is not harmful and does not result in complications, but it can occasionally mimic several other skin conditions that affect newborns, including:

Baby Acne (Acne Neonatorum)

Similar to adult acne, baby acne typically affects the forehead and cheeks. Maternal hormones are thought to play a role in the appearance of tiny red acnes. Without therapy, the condition usually goes away in a few months.

Milia

Your baby could get milia, a disorder where hard white bumps develop on the oil glands. Newborn babies typically have this condition on their forehead, chin, or nose. If left untreated, milia usually go away in a few weeks without leaving any marks. If milia is accompanied by skin irritation from specific bedding or clothing, the disease can appear similar to erythema toxicum neonatorum.

Prevention

There is no definite way to prevent erythema toxicum neonatorum from occurring, although you can take the following steps to stop the rashes from worsening or spreading:

• Refrain from giving your kid too many baths because their sensitive skin dries up quickly after using soap.
• Nodules packed with pus should not be scratched, squeezed, or have fluid removed (pustules). Doing so increases the likelihood of skin infections.
• Rashes are not required to be treated using creams and lotions. It's acceptable to carry on washing and moisturizing your baby's skin if you're used to doing so, just make sure the product is fragrance-free and designed specifically for baby's skin.

When to see a doctor?

If your baby develops skin rashes and you are unsure about the causes, consult a doctor. Also, if your baby gets skin rashes and other symptoms like fever, irritability, or refusal to be breastfed, consult a doctor. 

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