Monday, January 16, 2017

Neonatal Acne

Presented by Dr. Henry Foong, Ipoh Malaysia

21 day old boy
normal full term delivery
breast feeding
1 week history, initially forehead then spread too cheeks and nose area

mother is healthy and asymptomatic.

O/E: symmetrical/bilateral vesicles/ pustules/ papules/comedone on affected areas
 Dx: neonatal acne/ cephalic pustulosis
A benign condition.  i think it revolves with our treatment

Treatment:  reassurance!!

Comment by a pediatric dermatology colleague: "Neonatal acne is a common newborn eruption, and it can be seen in about 20% of healthy babies. The scalp, face, neck and back and chest are commonly affected, and open comedones are usually absent as this finding would make one consider infantile acne. The lesions are usually not present at birth, but typically appear within the first 2-4 weeks of life, and generally improve by about 4-6 months of age. This condition is self-limited, however, one can consider topical antifungal or low potency topical corticosteroid if the parents seek for medical treatment. Usually reassurance would comfort the parents." [The role of P. ovale is considered]


Neonatal Malassezia furfur pustulosis.
Rapelanoro R, et. al.
Arch Dermatol. 1996 Feb;132(2):190-3.
Papulopustular eruptions of the face in neonates are frequently referred to as neonatal acne or sebaceous miliaria. Our findings suggest that there is an association between this type of eruption and Malassezia furfur infection.
Direct examination of pustule smears showed M furfur yeasts in eight of 13 cases involving neonates with erythema and papulopustules of the face, neck, and scalp (mean age at onset, 22 days [range, 7 to 30 days]). The pustules were predominantly neutrophilic. Treatment with 2% ketoconazole cream applied topically twice daily was effective in 1 week.
Malassezia furfur is frequently associated with a common nonfollicular pustulosis of the newborn, probably improperly termed neonatal acne.

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