A 2-week-old infant is brought to the office for her first well-baby check. The parents noticed a rash on the face. You diagnose the white spots on the bridge of the nose as milia and neonatal acne on the cheeks. The parents are happy to hear that the neonatal acne and milia will go away without treatment (Figures 108-1 and 108-2).
Figure 108-1Graphic Jump Location
Milia on the face of a 2-week-old infant with greatest number of milia on the nose. (Courtesy of Richard P. Usatine, MD.)
- Rashes are common in newborns. Physicians will be consulted frequently as they are a common parental concern. Almost all newborn rashes are benign; however, a few are associated with more serious conditions. A newborn's skin shows a variety of changes during the first 2 months of life and most are self-limited. Physicians must be prepared to identify common rashes and advise parents.1
- Milia are inclusion cysts that appear as tiny white papules in the skin (Figure 108-1) or on the roof of the mouth.
- Neonatal acne is an acneiform eruption appearing as small red papules or whiteheads with surrounding erythema on the skin of newborns (Figure 108-2).
- A mongolian spot is a hereditary, congenital macule of bluish-black or bluish-gray pigment usually in the sacral area, back, and buttocks of infants (Figures 108-3 and 108-4).
- Erythema toxicum neonatorum (ETN) is a benign, self-limited skin eruption appearing as small yellow-white papules or vesicles with surrounding skin erythema (Figures 108-5 and 108-6).
Figure 108-3Graphic Jump Location
Large mongolian spots covering the buttocks and back of a Hispanic infant. (Courtesy of Richard P. Usatine, MD.)
Figure 108-4Graphic Jump Location
Prominent mongolian spots on the back of a 1-year-old black child. (Courtesy of Richard P. Usatine, MD.)
Figure 108-5Graphic Jump Location
One small spot of ETN on a 2-day-old infant. (Courtesy of Richard P. Usatine, MD.)
Figure 108-6Graphic Jump Location
More widespread case of ETN covering the infant. ETN is completely benign and will resolve spontaneously. (Courtesy of the University of Texas Health Sciences Center, Division of Dermatology.)
- Milia are also called milk spots or oil seed.
- Neonatal acne is also called acne neonatorum.
- Mongolian spots are also known as mongolian blue spots, congenital dermal melanocytosis, and dermal melanocytosis.
- Approximately 40% of newborn infants in the United States develop milia.2...