A full-term infant is evaluated in the newborn nursery at 18 hours of life. The pregnancy was uncomplicated, and maternal prenatal serologies were negative. The infant transitioned smoothly after birth, maintaining stable vital signs. Current temperature is 37.0°C (98.6°F), pulse is 142/min, and respirations are 42/min. On physical examination, the physician notes numerous 1- to 2-mm, firm, pearly-white papules densely clustered on the nasal bridge, chin, and forehead. There is no surrounding erythema or purulence. The remainder of the examination, including cardiopulmonary and neurologic assessments, is unremarkable. Which of the following is the most appropriate next step in the management of this patient?
- Reassurance of the parents without additional interventionCevap
- BAdmission to the neonatal intensive care unit for empiric systemic antibiotics
- CTrial of a topical antibacterial ointment
- DPrescription of a topical corticosteroid formulation
- EMechanical extraction of the keratinous material
Cevap
Reassurance of the parents without additional intervention
The correct response involves recognizing milia and providing reassurance. Milia present as multiple 1- to 2-mm, pearly-white or yellow papules predominantly on the face (especially the nose, cheeks, and chin) of newborns. They are epidermal inclusion cysts containing trapped keratin and sebaceous material. Because milia are a benign, physiologic finding that exfoliates and resolves spontaneously within the first few weeks to months of life, no medical or surgical intervention is required. Reassurance is the only necessary step.
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Anahtar Kavram
Diagnosis and management of benign neonatal rashes (Milia)