A pediatrician is examining several newborns in the nursery and noting various benign dermatologic findings. Connect the following neonatal clinical vignettes with their most appropriate diagnosis.
- A 48-hour-old term infant develops splotchy erythematous macules with central tiny pale papules on the chest and back. A smear of the pustules reveals numerous eosinophils.Erythema toxicum neonatorum
- A 2-hour-old term neonate presents with scattered superficial pustules that easily rupture, leaving behind hyperpigmented macules surrounded by a fine collarette of scale.Transient neonatal pustular melanosis
- A 3-day-old infant is noted to have multiple 1- to 2-mm firm, pearly-white papules clustered over the nose, chin, and upper lip without surrounding erythema.Milia
- A 12-hour-old newborn of Asian descent is found to have a well-demarcated, flat, dark blue-gray patch covering the lower back and buttocks.Congenital dermal melanocytosis
Answer
The splotchy rash with eosinophils corresponds to Erythema toxicum neonatorum. The pustules leaving hyperpigmented macules with scale correspond to Transient neonatal pustular melanosis. The pearly-white facial papules are Milia. The blue-gray lower back patch is Congenital dermal melanocytosis.
The correct matches rely on distinguishing the characteristic timing, physical appearance, and cellular composition of these benign neonatal skin findings.
Step-by-Step Solution
Key Concept
Differentiation of benign neonatal dermatologic conditions based on timing of onset, characteristic physical exam findings, and cellular composition.