Incidence of Vesicobullous and Erosive Disorders of Neonates: Where and How Much to Worry?

OBJECTIVE: To analyse the incidence of dermatoses in neonates, stress the importance of simple noninvasive diagnostic procedures with perspective to actual need of active intervention.

METHODS: Forty four neonates with vesicobullous lesions in Departments of Dermatology and Pediatrics were evaluated with respect to diagnosis, required treatments and follow ups.

RESULTS: Of the total 44 neonates, 29 were boys and 15 girls. Low birth weight (weight at birth less than 2,500 g as per WHO criteria) was seen in 19 neonates. Of the infectious dermatoses, most common were pyodermas. Four cases (9%) were diagnosed to be of staphylococcal pyoderma and impetigo and two cases each of Group A Streptococcal impetigo and neonatal tinea faciei (4.5% each), one case each of neonatal candidiasis, neonatal varicella/chickenpox and scabies (2.3% each) were seen. Of the transient skin lesions, erythema toxicum neonatorum was commonest of all, being seen in 18 neonates (41%), followed by four cases (9%) of miliaria crystallina, three cases of neonatal acne (6.8%) and two cases of sucking blisters (4.5%) and one case each of transient neonatal pustular melanosis, epidermolysis bullosa simplex, incontinentia pigmentii, eosinophilic pustular folliculitis, pemphigus vulgaris and neonatal herpes simplex (2.3% each) were enrolled in this study (Fig. 1). Fig. 1 Piechart showing percentage and number of neonates with different diagnostic profiles in the study CONCLUSIONS: Certain specific considerations have to be born in mind while evaluating and managing neonatal dermatoses. Care has to be instituted to identify accurately infectious diseases and distinguish them from benign transient neonatal dermatoses. Some disorders first manifesting during the neonatal period may also represent harbingers of potential problems during adulthood. Finally, treatment modalities are instituted taking in account the actual diagnosis and judging if the treatment really is required or not.