Erythema toxicum and pustular melanosis

Ajouté : 2026-05-23

[00:00:01]So uh toxic neonattorum of course it has a plethora of presentations and in some cases it's quite flid and maybe worrying but the good thing is that the baby always looks well. So that's a big clue for you that it's normal rash. It's an inflammatory disorder which is transient and is of unknown ideology. So we blame allergy, we blame esnopil infiltration, we blame the hormone withdrawal but nobody knows exact reason. The vesicular fluid shows is noils and it's probably an adaptation to the exposure. It's not common in premature babies. It's more common in the term babies and it usually appears by day 1 to three. One of you had commented about whether it can be present in the first few hours. Yes, I've seen many babies where it starts in the first few hours and it's not abnormal or unusual to see that it doesn't roll it out. Uh it's usually milder to start with and then the next day it spreads quite a bit. you have blotchy eratus macules. Uh you often have central papules and so you see the white areas are the papules and the surrounding armatus macules. In some cases it overlaps with postular melaninosis. So you it may be confusing if you're worried about herpes and you want edma around the lesions as a guide.

[00:01:14]This will be quite confusing to you. So the well-looking child with quite a generalized pattern is against herpus.

[00:01:20]It'll be more of a toxicum with postular melanosis. So it typically resolves within 5 to 7 days and this is what we discussed as postular melaninosis. It's more common in the pigmented races. Uh the baby may may be born with some peeling rash and that's a milder form of the postul melanosis. You see small white flakes and the next day it peels off. Even here the postular melanosis the postules may be more prominent in some parts like the groin the axilla under the neck and uh you may be confused whether to treat it with antistaff treatment but if it is present from day one and you have the postcular lesions on the other parts of the body or it's very small pastules you don't need to treat the larger pastules I mean ble like lesions you can consider fusedin if the baby is clinically unwell of course you have to consider treatment staff typically there is no audma around these lesions but in stylocal lesions you may see some edthema as well.

[00:02:19]So it occurs in 5% of dark newborns and less than 1% of caucasians. There is no surrounding arythema. They rupture easily leaving a colative scale and a pigmented macule. The pigmentation may take time to resolve and it can affect the palms and soles as well. I think some of you had shared an example recently.