Zuniga Ramiro, Nguyen Tam
San Joaquin General Hospital, French Camp, CA 95231, USA.
FP Essent. 2013 Apr;407:31-41.
Infants exhibit many skin rashes. Erythema toxicum neonatorum presents as erythematous macules, papules, and pustules on the face, trunk, and extremities; it typically resolves spontaneously within 1 week. Neonatal acne presents as comedones or erythematous papules on the face, scalp, chest, and back. Infantile acne is similar but starts after the neonatal period. Both conditions typically resolve spontaneously; failure to resolve within 1 year warrants evaluation for androgen excess. Neonatal cephalic pustulosis is an acne variant caused by hypersensitivity to Malassezia furfur. It is typically self-limited, but severe cases are managed with topical ketoconazole. Miliaria and milia are caused by sweat retention and present as tiny vesicles or papules; they resolve spontaneously. Contact diaper dermatitis is managed by keeping the diaper area clean and with open air exposure. Diaper dermatitis due to Candida albicans is managed with topical antifungals. Seborrheic dermatitis causes scaling on the scalp. Management involves shampooing and removing scales with a soft brush after applying mineral oil or petrolatum; severe cases are managed with tar or ketoconazole shampoo. Atopic dermatitis is related to food allergy in approximately one-third of children. Food allergy can be confirmed with oral food challenges or skin prick tests. Management includes elimination of irritants and triggers and use of low-potency topical steroids.
婴儿会出现多种皮疹。新生儿毒性红斑表现为面部、躯干和四肢的红斑、丘疹和脓疱;通常在1周内自行消退。新生儿痤疮表现为面部、头皮、胸部和背部的粉刺或红斑丘疹。婴儿痤疮与之相似,但在新生儿期之后开始出现。这两种情况通常都会自行消退;1年内未消退则需要评估是否存在雄激素过多的情况。新生儿头部脓疱病是一种由对糠秕马拉色菌过敏引起的痤疮变体。它通常是自限性的,但严重病例可用外用酮康唑治疗。痱子和粟丘疹是由汗液潴留引起的,表现为微小水疱或丘疹;它们会自行消退。接触性尿布皮炎通过保持尿布区域清洁并暴露在空气中来处理。白色念珠菌引起的尿布皮炎用外用抗真菌药治疗。脂溢性皮炎会导致头皮脱屑。处理方法包括使用矿物油或凡士林后洗头并用软刷去除鳞屑;严重病例用焦油或酮康唑洗发水治疗。约三分之一的儿童特应性皮炎与食物过敏有关。食物过敏可通过口服食物激发试验或皮肤点刺试验来确诊。处理措施包括消除刺激物和触发因素以及使用低效外用类固醇。