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儿童常见皮肤病:新生儿皮肤病变

Common Skin Conditions in Children: Neonatal Skin Lesions.

作者信息

Rayala Brian Z, Morrell Dean S

机构信息

University of North Carolina Chapel Hill School of Medicine Department of Family Medicine, 590 Manning Drive, Chapel Hill, NC 27599.

University of North Carolina Chapel Hill School of Medicine Dermatology Residency Program, 410 Market St. Suite 400 CB#7715, Chapel Hill, NC 27516.

出版信息

FP Essent. 2017 Feb;453:11-17.

Abstract

Skin findings during the initial month of life are ubiquitous. One study estimated that more than 95% of newborns have cutaneous findings, which often are distressing to parents but frequently are benign and self-limited. Among them are milia, cutis marmorata, congenital dermal melanocytosis, and the benign neonatal pustular eruptions (eg, benign cephalic pustulosis, erythema toxicum neonatorum, transient neonatal pustular melanosis). Clinicians need to recognize these benign skin conditions and differentiate them from more serious conditions, such as infectious pustular eruptions from bacterial, viral, and fungal causes, and inflammatory conditions, such as Langerhans cell histiocytosis. Notable bacterial pustular eruptions are bullous impetigo and congenital syphilis. Viral pustular dermatoses include neonatal herpes simplex virus infection and varicella zoster virus infection, which consists of congenital varicella syndrome, perinatal varicella, and infantile zoster. Fungal pustular eruptions include congenital and neonatal candidiasis. Seborrheic dermatitis is a self-limited condition that occurs with varying severity; symptomatic treatment is reserved for the more severe forms. Diaper dermatitis encompasses a broad clinical diagnosis, including allergic and irritant contact dermatitis, atopic dermatitis, infections, psoriasis, and other dermatologic conditions. Critical components of newborn skin care are immersion bathing, umbilical cord care, and use of emollients to augment skin barrier function.

摘要

出生后第一个月内出现皮肤表现很常见。一项研究估计,超过95%的新生儿有皮肤表现,这往往令父母担忧,但通常是良性且自限性的。其中包括粟丘疹、大理石样皮肤、先天性真皮黑素细胞增多症以及良性新生儿脓疱性皮疹(如良性头部脓疱病、新生儿毒性红斑、短暂性新生儿脓疱性黑素沉着)。临床医生需要识别这些良性皮肤状况,并将它们与更严重的状况区分开来,比如由细菌、病毒和真菌引起的感染性脓疱性皮疹,以及炎症性疾病,如朗格汉斯细胞组织细胞增多症。值得注意的细菌性脓疱性皮疹有大疱性脓疱疮和先天性梅毒。病毒性脓疱性皮肤病包括新生儿单纯疱疹病毒感染和水痘带状疱疹病毒感染,后者包括先天性水痘综合征、围产期水痘和婴儿带状疱疹。真菌性脓疱性皮疹包括先天性和新生儿念珠菌病。脂溢性皮炎是一种自限性疾病,严重程度各异;症状较重的形式需进行对症治疗。尿布皮炎包含广泛的临床诊断,包括过敏性和刺激性接触性皮炎、特应性皮炎、感染、银屑病及其他皮肤病。新生儿皮肤护理的关键环节包括浸浴、脐带护理以及使用润肤剂增强皮肤屏障功能。

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