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Polaskey MT, Chang CH, Daftary K, Fakhraie S, Miller CH, Chovatiya R. The Global Prevalence of Seborrheic Dermatitis: A Systematic Review and Meta-Analysis. JAMA Dermatol 2024:2820685. [PMID: 38958996 PMCID: PMC11223058 DOI: 10.1001/jamadermatol.2024.1987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/05/2024] [Indexed: 07/04/2024]
Abstract
Importance Seborrheic dermatitis is a prevalent chronic inflammatory skin disease, yet its global prevalence, pathogenesis, and epidemiology remain inadequately defined. Objective To provide a detailed estimation of the global prevalence of seborrheic dermatitis, analyze demographic variations, and explore differences in various settings. Data Sources Embase, PubMed, Scopus, and Cochrane Database of Systematic Reviews were searched from inception through October 2023. Study Selection Original investigations on seborrheic dermatitis prevalence were included after duplicate screening of titles, abstracts, and full articles, including only studies with clinician-diagnosed cases. Data Extraction and Synthesis Following PRISMA guidelines, data were extracted and quality was assessed independently by multiple reviewers. A random-effects model using restricted maximum likelihood was used for meta-analysis and subgroup analyses. Main Outcome and Measure The primary outcome was the pooled estimate of global seborrheic dermatitis prevalence. Results From 1574 identified articles, 121 studies were included, encompassing 1 260 163 individuals and revealing a pooled global seborrheic dermatitis prevalence of 4.38% (95% CI, 3.58%-5.17%), with significant heterogeneity (I2 = 99.94%). Subgroup analyses showed variations by age, with a higher prevalence in adults (5.64% [95% CI, 4.01%-7.27%]) compared to children (3.70% [95% CI, 2.69%-4.80%]) and neonates (0.23% [95% CI, 0.04%-0.43%]). Geographic analyses indicated variability, with the highest prevalence in South Africa (8.82% [95% CI, 3.00%-14.64%]) and the lowest in India (2.62% [95% CI, 1.33%-3.92%]). Conclusions and Relevance This comprehensive meta-analysis provides a detailed estimation of the global prevalence of seborrheic dermatitis, highlighting significant variability across different demographics and settings.
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Affiliation(s)
- Meredith Tyree Polaskey
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Karishma Daftary
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Sheiva Fakhraie
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Corinne H. Miller
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Raj Chovatiya
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois
- Center for Medical Dermatology and Immunology Research, Chicago, Illinois
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Ramos MCM, Velasco MVR, Bueno M, Veríssimo MDLÓR. Effects of Liquid and Bar Soaps on the Skin of Brazilian Newborns: A Randomized Controlled Trial. Skin Pharmacol Physiol 2024; 36:267-277. [PMID: 38262395 DOI: 10.1159/000536066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/21/2023] [Indexed: 01/25/2024]
Abstract
INTRODUCTION Compared to adults, newborns' skin has a thinner epidermis and stratum corneum with decreased hydration levels, higher transepidermal water loss, and a pH variation between 5.5 and 7.5. These characteristics can predispose to the occurrence of dryness, infections, and dermatological conditions. Water and liquid soap with adequate formulation have shown to be beneficial and safe for newborns' skin. However, studies evaluating the effect of bar soap, products widely used in Brazil and Latin America, are unknown. Therefore, the objective of this study was to compare the effects of liquid and bar soaps on the term newborns' skin. METHODS This randomized controlled, parallel, single-blind clinical trial was conducted at a public university hospital in São Paulo, Brazil. 100 healthy term newborns with no congenital anomalies, acute diseases, or dermatological conditions were randomized to use liquid soap (experimental group) or bar soap (control group). Skin pH, transepidermal water loss, stratum corneum hydration, sebum content, and skin condition were assessed before and after the first bath, at 48 h, 14 days, and 28 days after birth. These evaluations were performed on the forearm, abdomen, buttocks, and thigh. In addition, the mother's perception of soap use was also evaluated. RESULTS Data of 100 newborns were analyzed by intention to treat. The rate of retention was 53%. Newborns exposed to the liquid soap presented significantly better skin acidification (p < 0.001) and significantly better stratum corneum hydration (p < 0.001) than the skin of newborns exposed to the bar soap, regardless of the area evaluated. There were no significant differences in transepidermal water loss, sebum content, dryness, erythema, or skin breakdown and the mother's perceptions of the use of the soaps. CONCLUSION Newborns in the experimental group presented better skin acidification and stratum corneum hydration when compared to newborns in the control group.
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Affiliation(s)
| | | | - Mariana Bueno
- Peter Gilgan Centre For Research and Learning (PGCRL), Hospital For Sick Children Foundation, Toronto, Ontario, Canada
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Zanatta DA, Carvalho VO, da Silva RPGVC. What the skin of 341 premature newborns says - a transversal study. J Pediatr (Rio J) 2023; 99:582-587. [PMID: 37172615 PMCID: PMC10594010 DOI: 10.1016/j.jped.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVES Determine the frequency of dermatological diagnoses in preterm newborns up to 28 days of life and associated perinatal factors. METHOD a cross-sectional analytical study with a convenience sample and prospective data collection, was conducted between November 2017 and August 2019. Overall, 341 preterm newborns who had been admitted to a University hospital - including those admitted to the Neonatal Intensive Care Unit - were evaluated. RESULTS 61 (17.9%) had less than 32 weeks gestational age (GA), with a mean GA and birth weight of 33.9 ± 2.8 weeks and 2107.8 ± 679.8g (465 to 4230g), respectively. The median age at the time of evaluation was 2.9 days (4 h to 27 days). The frequency of dermatological diagnoses was 100% and 98.5% of the sample had two or more, with an average of 4.67+1.53 dermatoses for each newborn. The 10 most frequent diagnoses were lanugo (85.9%), salmon patch (72.4%), sebaceous hyperplasia (68.6%), physiological desquamation (54.8%), dermal melanocytosis (38.7%), Epstein pearls (37.2%), milia (32.2%), traumatic skin lesions (24%), toxic erythema (16.7%), and contact dermatitis (5%). Those with GA< 28 weeks showed more traumatic injuries and abrasions, whereas those with ≥ 28 weeks had physiological changes more frequently, and those with GA between 34-366/7 weeks, had transient changes. CONCLUSION Dermatological diagnoses were frequent in our sample and those with higher GA showed a higher frequency of physiological (lanugo and salmon patch) and transient changes (toxic erythema and miliaria). Traumatic lesions and contact dermatitis were among the 10 most frequent injuries, reinforcing the need to effectively implement neonatal skin care protocols, especially in preterm.
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Affiliation(s)
- Danielle Arake Zanatta
- Hospital de Clínicas da Universidade Federal do Paraná (UFPR), Departamento de Pediatria, Unidade de Dermatologia Pediátrica, Curitiba, PR, Brasil.
| | - Vânia Oliveira Carvalho
- Hospital de Clínicas da Universidade Federal do Paraná (UFPR), Departamento de Pediatria, Unidade de Dermatologia Pediátrica, Curitiba, PR, Brasil
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Yonezawa K, Haruna M. Relationship Between Degree of Neonatal Physiologic Desquamation and Skin Barrier Function. J Perinat Neonatal Nurs 2023; 37:348-353. [PMID: 37115943 DOI: 10.1097/jpn.0000000000000694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
BACKGROUND/OBJECTIVES This study examined the relationship between degree of neonatal physiologic desquamation and skin barrier functionality. In addition, we identified factors associated with neonatal desquamation. METHODS This cross-sectional study assessed 4-day-old newborns. The desquamation level was evaluated and placed in one of the following categories based on the severity of the desquamation: no desquamation, a small amount, and severe (including cracked or bleeding). Skin barrier function was assessed by evaluating transepidermal water loss, stratum corneum hydration, skin pH, and sebum secretion. RESULTS Among study participants, 67 (39.9%) showed no desquamation, 82 (48.8%) displayed a small amount, and 19 (11.3%) had severe desquamation. The group with severe desquamation had significantly elevated facial transepidermal water loss levels and reduced levels of stratum corneum hydration throughout the body, indicating skin barrier dysfunction, than other groups. In addition, the group with severe desquamation had a significantly longer gestational age, lower temperature and humidity level, smaller vernix caseosa, and tended to be born during winter. CONCLUSIONS To our knowledge, this is the first report indicating that infants with severe desquamation had worsened skin barrier function versus those with moderate and no desquamation. Future research should consider what kind of care should be provided to newborns with severe desquamation.
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Affiliation(s)
- Kaori Yonezawa
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Drs Yonezawa and Haruna); and Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Drs Yonezawa and Haruna)
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Yu L, Qin K, Deng X, Yao X, Deng Y, He W, Liu QW, Tang Y, Yang H, Wang Z, Zhu Z, Zhang T. Epidemiological study of capillary malformation among 7299 infants under 1 year of age in China. J Eur Acad Dermatol Venereol 2023; 37:627-632. [PMID: 36448684 DOI: 10.1111/jdv.18767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 11/09/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Capillary malformation (CM) is the most common vascular malformation. Large scale studies on its incidence and risk factors are limited in China. OBJECTIVE Our study aimed to investigate the incidence of CM in Chinese infants and to evaluate its potential risk factors. METHODS A cross-sectional study, including 7299 infants (aged < 1 year) were collected by a self-administered questionnaire. Independent-samples T tests or χ2 tests and multivariable logistic models were used to examine the potential risk factors for CM. RESULTS The incidences of salmon patches and port-wine stains (PWSs) were 9.10% and 0.80%, respectively. In analyses, male sex (OR: 1.32, 95% CI: 1.12-1.55) and birth hypoxia (OR: 5.61, 95% CI: 4.39-7.16) were risk factors for salmon patches. Birth hypoxia (OR: 12.58, 95% CI: 7.26-21.79) and pregnancy-induced hypertension syndrome (PIH; OR: 3.66, 95% CI: 1.49-8.99) were associated with a higher risk of PWSs. CONCLUSION This epidemiological study had the largest sample size of infants with CM in the world thus far, which updated its incidence in Chinese infants and found the potential risk factors for CM.
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Affiliation(s)
- Lei Yu
- Department of Dermatology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Kun Qin
- Department of Dermatology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,Department of Dermatology, Jiangmen Central Hospital, Jiangmen, China
| | - Xianming Deng
- Department of Neurosurgery, Jiangmen Central Hospital, Jiangmen, China
| | - Xiaojian Yao
- Department of Dermatology, The Fifth People's Hospital of Nanhai District, Foshan City, China
| | - Yuhong Deng
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Wanying He
- Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Qi-Wen Liu
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Yichun Tang
- Department of Pathology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Hong Yang
- Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhengyuan Wang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhaohua Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,Orthopedic Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Tangde Zhang
- Department of Dermatology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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6
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Xie F, Zhu Y, Chen L, Han R, Shu Q, Chen ZY, Li J. The Disease Spectrum and Influencing Factors of NICU in Xiangxi, Underdeveloped Area of China: A 9-Year Retrospective Study. Front Pediatr 2022; 10:874586. [PMID: 35783321 PMCID: PMC9247320 DOI: 10.3389/fped.2022.874586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Investigation of the basic conditions and disease spectrum in neonatal intensive care unit (NICU) from 2012 to 2020, in the underdeveloped area of Xiangxi, China. METHODS All newborns (N = 16,094) admitted to the NICU of a hospital in the Xiangxi area from 2012 to 2020 were selected for the retrospective study. RESULTS The average male/female ratio was 1.43:1, with 9,482 males and 6,612 females admitted to the NICU. The sample comprised 41.02% premature infants, and 56.52% had been delivered via cesarean delivery (CD). The most prevalent diseases diagnosed in the NICU were jaundice (22.01%), respiratory (18.45%) and neurological diseases (17.54%). Over the 9-year study window, the prevalence of jaundice and cardiovascular diseases increased, while respiratory and neurological diseases became less frequent. The prevalence of the remaining diseases remained unchanged. Prevalence of neonatal diseases is influenced by gender, patient sources, delivery methods, gestational age and birth weight (P < 0.05). The prevalence of neonatal diseases was significantly higher in males, infants born via CD, and in infants of lower gestational age and birth weight. CONCLUSION The study contributes in-depth information about infant characteristics in an NICU in an undeveloped region of China. In the past 9 years, the average proportion of premature infants in the NICU decreased to 37.38% in 2020, but this figure remains higher than the Chinese national average of 26.2%. Similarly, the CD rate is higher than the Chinese average. The spectrum of neonatal diseases in the NICU in Xiangxi area is drawn, included jaundice, respiratory and neurological diseases, primarily. Through statistical analysis, it is found that the types and prevalence of neonatal diseases are closely related to different gender, gestational age, patient sources, delivery methods, and birth weight (P < 0.05). Newborns of specific gestational age, birth weight and delivery method should be considered "at-risk" and targeted in the formulation of preventive measures. There is a great need to improve the diagnosis and treatment of neonatal diseases-and perinatal health care in general-to ensure improved outcomes for newborns admitted to NICUs in underdeveloped regions.
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Affiliation(s)
- Fen Xie
- Department of Nursing, Jishou University School of Medicine, Jishou, China.,Department of Neonatology, The Fourth Affiliated Hospital of Jishou University (The First People's Hospital of Huaihua), Huaihua, China
| | - Yuhua Zhu
- Department of Nursing, Jishou University School of Medicine, Jishou, China.,Department of Neonatology, The Fourth Affiliated Hospital of Jishou University (The First People's Hospital of Huaihua), Huaihua, China
| | - Lulu Chen
- Department of Nursing, Jishou University School of Medicine, Jishou, China.,Department of Neonatology, The Fourth Affiliated Hospital of Jishou University (The First People's Hospital of Huaihua), Huaihua, China
| | - Ruyi Han
- Department of Nursing, Jishou University School of Medicine, Jishou, China.,Department of Neonatology, The Fourth Affiliated Hospital of Jishou University (The First People's Hospital of Huaihua), Huaihua, China
| | - Qingxia Shu
- Department of Neonatology, The Fourth Affiliated Hospital of Jishou University (The First People's Hospital of Huaihua), Huaihua, China
| | - Zheng-Ying Chen
- Department of Nursing, Jishou University School of Medicine, Jishou, China
| | - Jinxiu Li
- Department of Nursing, Jishou University School of Medicine, Jishou, China
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7
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Mecarini F, Fanos V, Crisponi G. Genital anomalies in newborns. J Perinatol 2021; 41:2124-2133. [PMID: 33649448 DOI: 10.1038/s41372-021-00991-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 01/15/2021] [Accepted: 02/03/2021] [Indexed: 02/05/2023]
Abstract
Examination of genitalia should be an essential part of newborn assessment. Early detection of congenital disorders is essential to begin appropriate medical or surgical therapy and to prevent complications that could profoundly affect a child's life. The present review aims to describe the main genital anomalies in infants and provide images in order to help the physician in current clinical practice.
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Affiliation(s)
- Federico Mecarini
- Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy.
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy
| | - Giangiorgio Crisponi
- Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy
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Juzot C, Aubert H, Bessis D, Boccara O, Bourrat E, Chiaverini C, Flamant C, Fournet M, Hubiche T, Labrèze C, Martin L, Piram M, Seta V, Finon A, Maruani A, Barbarot S. Transient abdominal telangiectasia of the newborn. Pediatr Dermatol 2021; 38:864-867. [PMID: 34152036 DOI: 10.1111/pde.14620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
We report 20 newborns who developed, at a median age of 7 days, large abdominal patches of radially arranged purplish telangiectasia in a bilateral and symmetrical pattern in relation to the midline, creating a "butterfly wing" pattern. Clinical examination was normal in 13 newborns, six newborns had abdominal distention, and one newborn had poor weight gain due to inadequate breastfeeding. Most lesions spontaneously resolved within 3 months and did not reoccur for 19 newborns. Transient abdominal telangiectasia of the newborn (TATN) appears to be a distinctive entity that has not been previously described.
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Affiliation(s)
- Cécile Juzot
- Department of Dermatology, University Hospital of Nantes, Nantes, France
| | - Hélène Aubert
- Department of Dermatology, University Hospital of Nantes, Nantes, France
| | - Didier Bessis
- Department of Dermatology, University Hospital of Montpellier, Montpellier, France
| | - Olivia Boccara
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Paris University, Imagine Institute, Necker-Enfants Malades University Hospital, APHP5, Paris, France
| | - Emmanuelle Bourrat
- Department of General Pediatrics, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Cyril Flamant
- Department of Neonatal Medicine, University Hospital of Nantes, Nantes, France
| | - Marine Fournet
- Department of Pediatric Dermatology, Hôpital Pellegrin-Enfants, University Hospital of Bordeaux, Bordeaux, France
| | - Thomas Hubiche
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - Christine Labrèze
- Department of Dematology, Pellegrin Children's Hospital, Bordeaux, France
| | - Ludovic Martin
- Department of Dermatology, University Hospital of Angers, Angers, France
| | - Maryam Piram
- Department of Pediatrics, Division of Dermatology, CHU Sainte Justine Research Center, CHU Sainte Justine, University of Montréal, Montréal, QC, Canada
| | - Vannina Seta
- Department of Dermatology, Cochin University Hospital, Paris, France
| | - Antoine Finon
- Department of Dermatology, Orléans Hospital, Orléans, France
| | - Annabel Maruani
- Department of Dermatology, Unit of Pediatric Dermatology, University of Tours, Inserm 1246-SPHERE, CHRU Tours, Tours, France
| | - Sébastien Barbarot
- Department of Dermatology, Nantes University, CHU Nantes, UMR 1280 PhAN, INRA, Nantes, France
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Neonatal Dermatologic Findings in Uruguay: Epidemiology and Predisposing Factors. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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10
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Aktaş H, Alp Erdal S. Oral mucosal and skin lesions observed in the first 48 hr in newborns. J Cosmet Dermatol 2021; 20:3649-3655. [PMID: 33609325 DOI: 10.1111/jocd.14013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/10/2021] [Accepted: 02/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Newborn period is a definition used for the first 4 weeks of life and it has some different characteristics compared with adult skin. AIMS In this study, we tried to define the pathological and physiological skin manifestations and demographic data observed in newborns PATIENTS/METHODS: In this study, newborns born between 2018 and 2019 were evaluated prospectively. Along with demographic findings, temporary neonatal skin manifestations, congenital spots, benign neonatal pustulosis, congenital anomalies and other lesions were statistically evaluated. RESULTS A total of 2109 newborns, consisting of 1157 (54.9%) boys and 952 (45.1%) girls, were enrolled in the study. 94% of the newborns evaluated had at least one skin lesion. The most common skin manifestations in the study were Epstein pearls at a rate of 49.4%. This was followed by salmon patch (38.4%), Mongolian spot (20.1%), edema in the eyelids (15.5%), lanugo (15.4%), and erythema toxicum neonatarum (11.6%), respectively. CONCLUSION Several studies on dermatological findings observed in newborns have been conducted in many different countries around the world. In this study, we tried to identify many temporary and pathological skin manifestations and congenital anomalies observed in the first 48 h in newborns.
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Affiliation(s)
- Hamza Aktaş
- Private Memorial Hospital Department of Dermatology, Diyarbakır, Turkey
| | - Semahat Alp Erdal
- Department of Dermatology, Health Sciences University Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
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11
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A Case of Eosinophilic Pustular Folliculitis since Birth. CHILDREN-BASEL 2021; 8:children8010030. [PMID: 33430336 PMCID: PMC7825765 DOI: 10.3390/children8010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 11/17/2022]
Abstract
A newborn male infant presented with multiple pustules and erosions with erythema involving his scalp and forehead at birth. One week after birth, new pustules continued to appear, forming crusted, ring-shaped plaques with pigmentation. Tests for possible pathogens were negative. Tzanck smear and skin biopsy revealed pustules beneath the stratum corneum at sites corresponding to hair follicles, which contained eosinophils and neutrophils. Taken together, a diagnosis of eosinophilic pustular folliculitis (EPF) was made. The pustules on the head disappeared rapidly with topical corticosteroid treatment, although new eruptions were still observed on the trunk about one month after birth. To our knowledge, only two cases of EPF since birth have been reported to date. Here, we also discuss the differential diagnosis of noninfectious pustular diseases at birth, including erythema toxicum neonatorum and transient neonatal pustular melanosis. These diseases, and EPF, may present with very similar clinical symptoms at birth, and the Tzanck test or biopsy may be required for differential diagnosis.
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12
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De María MK, Borda KM, Arretche VN, Gugelmeier N, Mombelli R, de Los Santos AV, Acosta MA, Álvarez M, Pose GL, Borbonet D, Martínez MA. Neonatal Dermatologic Findings in Uruguay: Epidemiology and Predisposing Factors. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:414-424. [PMID: 33321117 DOI: 10.1016/j.ad.2020.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 09/28/2020] [Accepted: 11/29/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The skin is a fundamental organ in the transition from intrauterine to extrauterine life. The newborn infant experiences physiological changes and often presents benign, transient skin characteristics that vary according to maternal, gestational, and neonatal factors. OBJECTIVES To estimate the frequency of various dermatologic findings during the first 72hours of life and to identify their association with maternal, gestational, or neonatal factors. METHODS Descriptive, observational, cross-sectional study from April to July 2015 and July to November 2017 in the maternity ward of Centro Hospitalario Pereira Rossell. We examined the skin of neonates within 72hours of birth. Proportions and 95% CI were calculated for all findings. Associations between findings and factors were analyzed. RESULTS A total of 2811 neonates were included. We observed at least one neonatal skin finding in all of the neonates and found a median (interquartile range) of 8 (6-9) findings (minimum-maximum, 1-16). We observed 42 of the 46 possible characteristics we looked for; 99.9% of the findings were benign and transient. Among the findings were lanugo (98%; 95% CI, 97.7%-98.7%), physiological scaling (79.7%; 95% CI: 78.2%-81.1%), and sebaceous hyperplasia (73.3%; 95% CI: 71.6%-74.9%). Lanugo (P=.001), physiological scaling (P<.001), and erythema toxicum (P=.001) were observed significantly more often in full- and late-term neonates. Sebaceous hyperplasia (P=.001) and transient hyperpigmentation (P<.001) were found more often in newborn males. Erythema toxicum was more common after vaginal births (P=.008). Transient hyperpigmentation (P<.001) and dermal melanocytosis (P<.001) were seen more often in neonates of African descent. CONCLUSIONS All neonates have skin characteristics that are part of their adaptation to extrauterine life. Most are benign and transient. Maternal age, type of delivery, and certain neonatal factors such as gestational age, birth weight, sex, and ethnicity are associated with specific findings.
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Affiliation(s)
- M K De María
- Cátedra de Neonatología, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay.
| | - K M Borda
- Cátedra de Neonatología, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - V N Arretche
- Cátedra de Dermatología Pediátrica, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - N Gugelmeier
- Cátedra de Dermatología Pediátrica, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - R Mombelli
- Cátedra de Neonatología, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - A V de Los Santos
- Cátedra de Neonatología, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - M A Acosta
- Cátedra de Dermatología Pediátrica, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - M Álvarez
- Cátedra de Dermatología Pediátrica, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - G L Pose
- Cátedra de Neonatología, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - D Borbonet
- Cátedra de Neonatología, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - M A Martínez
- Cátedra de Dermatología Pediátrica, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
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Cutaneous Lesions in Iranian Neonates and Their Relationships with Maternal-Neonatal Factors: A Prospective Cross-Sectional Study. Dermatol Res Pract 2020; 2020:8410165. [PMID: 32425998 PMCID: PMC7222559 DOI: 10.1155/2020/8410165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/20/2020] [Indexed: 11/17/2022] Open
Abstract
Cutaneous lesions are common in the neonatal period and mostly physiological, transient, and self-limited; uncommonly, they are pathological and require treatment and cooperation between neonatologists and dermatologists. Particular conditions, like prematurity, can influence the onset, type, and evolution of cutaneous manifestations. Of the several articles in the literature about skin findings in newborns, only a few were performed in Iran. We aimed to investigate dermatological findings in a sample of neonates within the first three days of life and to evaluate the association between skin lesions and neonatal- or maternal-related variables. A total of 1202 newborns, hospitalized in the Department of Pediatrics of Imam Sajjad Hospital of Ramsar and Shahid Rajaee Hospital of Tonekabon, Iran, for two years, were examined. All skin findings were recorded, and information on neonatal and maternal variables was collected and analyzed to detect statistically significant associations. Skin lesions were present in 958 newborns (79.8%). The prevalence of milia, erythema toxicum, salmon patch, and Mongolian spots were 45.2%, 43%, 37.3%, and 37%, respectively. Natural vaginal delivery, use of medication, term gestation, and maternal disease were associated with a higher incidence of cutaneous lesions in neonates. Milia, erythema toxicum, Mongolian spots, and genital hyperpigmentation were seen more frequently in the male gender. Conversely, skin desquamation was seen more frequently in females. Among maternal diseases, gestational diabetes mellitus, urinary tract infection, preeclampsia, hypertension, psychiatric disorders, and uterine infection were associated with a higher prevalence of cutaneous lesions. Neonatal cutaneous lesions are a common source of concern in parents and inexperienced physicians. Therefore, prompt recognition of neonatal cutaneous lesions is essential in order to avoid unnecessary diagnostic and therapeutic procedures.
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Abstract
Skin eruptions are commonly encountered in the neonatal and infant period and can be a source of concern for providers and parents alike. We present a brief, clinically focused discussion on topics commonly encountered by the pediatrician with a focus on pearls of knowledge to help distinguish diseases from one another and from more serious conditions. We review miliaria, transient neonatal pustular melanosis, neonatal cephalic pustulosis, erythema toxicum neonatorum, diaper dermatitis, seborrheic dermatitis, and atopic dermatitis. Treatment strategies are also discussed. [Pediatr Ann. 2019;48(1):e16-e22.].
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