Common Skin findings in newborn

Question 1

-Bluish discoloration of hands and feet -normal for the first 24-48 hrs of life due to immature cardiac circulation -may be seen in the older newborn due to cold stress

Answer 1

Acrocyanosis

Question 2

-unilateral color change on one side of the body -more common in low birth weight infants -due to autonomic instability -transient, harmless, lasts 10-20 mins

Answer 2

Harlequin sign

Question 3

-occurs abruptly in 30-70% of newborns -yellow or white, 1-3 mm papules over erythematous base -can occur anywhere on the body but usually spare the palmer surfaces -unknown cause

Answer 3

Erythema Toxicum

Question 4

-exposed sebaceous glands that appear as whiteheads - disappear within the first month of life - no treatment needed

Answer 4

milia

Question 5

-bluish grey pigmentation of the skin -typical locations: lower back, across the shoulders, hips and legs -more common in darker skin neonates -can fade over time ***always document so that they don’t get confused for non accidental trauma****

Answer 5

Mongolian spots

Question 6

-raised capillary nevi -can occur anywhere on the body - can increase in size over the first few months of life -generally disappear by age 10

Answer 6

Strawberry Hemangioma ***referral = orbital hemangioma, very large hemangioma or those with the potential to interfere with the airway***

Question 7

• pale pink or reddish discoloration of the skin
• location is nape of neck, the lower axilla, nasal bridge or eyelids
• more evident when child cries
• generally disappear by age 2, no treatment needed

Answer 7

Stork bites

Question 8

• fine, soft hair that covers the newborn’s back, shoulders, cheeks, forehead and scalp
• more common in premature infants
• disappears within the first month of life

Answer 8

Lanugo

Question 9

• line of increased pigmentation from umbilicus to gentalia
• more common in darker skinned infants

Answer 9

Linea Nigra

Question 10

• cheesy, gray- white substance covering and protecting the skin during fetal life
• generally diminishes near term

Answer 10

Vernix Caseosa

Question 11

• Yellowing of the skin, most visable after blanching
• Progression is head to toe
• can be physiologic or pathologic

Answer 11

Jaundice

Question 12

• appears at 3-4 weeks of age
• caused by maternal hormones stimulation of the sebaceous glands
• more common in males
• no treatment needed, in fact, topical lotions/ creams generally make lesions worse
• can occur anywhere on the body

Answer 12

Neonatal acne

Question 13

• pinpoint sized hemorrhage
• normal on presenting parts
• presence anywhere other than the presenting part could indicate infection
• workup would be warranted

Answer 13

Petechiae

Question 14

bluish discoloration of the skin

can be periorbital, circumoral or of the chest/ or abdomen

central cyanosis, pathologic cyanosisor due to hypoxemia

due to fetal Hgb, usually only visible at O2 sat < 60%

Requires assessment for pathologic condition

Answer 14

Cyanosis

Question 15

• hyper pigmented lesions, usually macules
• irregular is shape and light brown in color
• can be associated with pathologic conditions
• any newborn with 6 or greater than 1 cm requires a workup for neurofibromatosis

Answer 15

cafe au lait spots

Question 16

marbling or spiderweb appearance of newborn’s skin

can be due to hypothermia or infection

Answer 16

Mottling

Question 17

occurs in healthy newborn, appears the same but improved as skin is warmed

Answer 17

Cutis Marmorata

Question 18

paleness of the skin

in children with darker skin, evaluate the soles of the feet and the palms of the hands or circumorally

can occur with anemia and infection

Answer 18

Pallor