Pediatric Pearls: Neonatal Rashes

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Nurses Edition Commentary

Kathy Garvin, RN and Lisa Chavez, RN
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Eric L., PA-C -

What is being described in this talk as "neonatal acne" appears that it would more aptly be classified as "neonatal cephalic pustulosis". The former (infantile acne) though rarer, per UpToDate at least would be distinguished by presence of comedones and may require treatment due the potential for scarring. Thoughts on any distinction between these two conditions?

ilene c. -

Thank you for the question, and the impressive peds derm knowledge! To be completely technical, I we could look at these as 3 seperate things: neonatal cephalic pustulosis, neonatal acne and infantile acne. Neonatal cephalic pustulosis (scattered inflammatory papules and pustules are found on the face, scalp, and neck in infants days to weeks old) is often considered synonymous or a variant of neonatal acne, though there is an inflammatory component thought due to malassezia playing a role which differentiates it from simple acne. Typically both resolve without treatment (though you could treat the malassezia if you wanted, likely unneeded). Infantile acne often presents at 2-12 months and also typically resolves without treatment. If multiple large inflammed nodules, occasionally scarring is a concern but the vast majority of patients resolve without consequence.

James C. -

Fun fact: Harley Quinn's original costume is actually consistent with eh Harlequin rash, with halves of her body being red or black. https://upload.wikimedia.org/wikipedia/commons/thumb/d/dc/LSCC_2012_-_Harley_Quinn_%286932743701%29.jpg/640px-LSCC_2012_-_Harley_Quinn_%286932743701%29.jpg

ilene c. -

I didn't know that- so cool!

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