A 2-day-old male newborn is evaluated in the nursery for a new-onset skin rash. He was born at 39 weeks gestation via uncomplicated spontaneous vaginal delivery. Apgar scores were 8 and 9 at 1 and 5 minutes, respectively. The infant has been breastfeeding well and has had normal bowel and bladder function. Temperature is 37.1 C (98.8 F), heart rate is 140/min, and respiratory rate is 40/min. Physical examination reveals multiple erythematous macules and papules with central 1- to 2-mm yellow-white pustules scattered across the trunk and proximal extremities. The palms and soles are spared. The remainder of the examination is unremarkable. Which of the following is the most appropriate next step in management?
- AIntravenous acyclovir
- BIntravenous ampicillin and gentamicin
- Reassurance and observationCevap
- DSkin scraping for potassium hydroxide preparation
- ETopical mupirocin
Cevap
Reassurance and observation
The correct answer is reassurance and observation. The patient presents with classic features of erythema toxicum neonatorum (ETN), a benign, idiopathic eruption seen in up to 50% of full-term neonates. ETN typically appears in the first 24 to 72 hours of life and is characterized by erythematous macules, papules, and pustules distributed predominantly over the trunk and proximal extremities, sparing the palms and soles. The infant is otherwise entirely asymptomatic and well-appearing. The condition is self-limited, usually resolving without scarring within one week, so no diagnostic workup or pharmacologic treatment is necessary.
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Anahtar Kavram
Erythema toxicum neonatorum is a common, benign, self-limiting neonatal rash presenting as erythematous macules with central pustules on the trunk and extremities, managed solely with reassurance.