Erythema toxicum neonatorum: a retrospective review

ABSTRACT

To describe clinical manifestations, differential diagnosis, and treatment outcome of Erythema Toxicum Neonatorum in healthy newborns at King Hussein Medical Center and Queen Rania Children's Hospital. The medical records review was conducted for patients with clinical diagnosis of Erythema Toxicum Neonatorum who were treated at King Hussein Medical Center and Queen Rania Children's Hospital dermatology clinics between February 2008 and September 2012. Extracted data include duration of pregnancy, type of delivery, age, sex, cutaneous rash characteristics, associated clinical conditions, laboratory investigations, skin biopsy, and treatment. Simple statistical analyses [mean, frequency, and percentage] were used to describe the study variables. The study included 152 patients, 88 males and 64 females with a male to female ratio of 1.41. The age at onset of the rash ranged from one to 11 days [mean age was 4 days]. All subjects were products of hospital-based deliveries. The erythematous and papular type was the commonest [73.7%]. History of drug intake during pregnancy was found in about two thirds of cases [66%]. Four subjects [2.64%] had lymphadenopathy and five [3.22%] had moderate fever. Tzanck smear was done in 17 subjects with severe skin rash. Skin biopsy was done in four patients. About half cases received oral antihistamine treatment and the rashes disappeared over 24 to 36 hours. Follow up was done for four weeks. Erythema Toxicum Neonatorum is a self-limiting disease and without long term sequalae. More efforts are needed to raise awareness of this condition amongst health care professionals to avoid unnecessary investigations and treatment as it is sometimes misdiagnosed as bacterial infection