Yoshida Satoshi, Yatsuzuka Kazuki, Chigyo Kenji, Kuroo Yuta, Takemoto Koji, Sayama Koji
Department of Dermatology, Ehime University Graduate School of Medicine, Ehime 791-0295, Japan.
Department of Pediatrics, Ehime Prefectural Niihama Hospital, Ehime 792-0042, Japan.
Children (Basel). 2021 Jan 7;8(1):30. doi: 10.3390/children8010030.
A newborn male infant presented with multiple pustules and erosions with erythema involving his scalp and forehead at birth. One week after birth, new pustules continued to appear, forming crusted, ring-shaped plaques with pigmentation. Tests for possible pathogens were negative. Tzanck smear and skin biopsy revealed pustules beneath the stratum corneum at sites corresponding to hair follicles, which contained eosinophils and neutrophils. Taken together, a diagnosis of eosinophilic pustular folliculitis (EPF) was made. The pustules on the head disappeared rapidly with topical corticosteroid treatment, although new eruptions were still observed on the trunk about one month after birth. To our knowledge, only two cases of EPF since birth have been reported to date. Here, we also discuss the differential diagnosis of noninfectious pustular diseases at birth, including erythema toxicum neonatorum and transient neonatal pustular melanosis. These diseases, and EPF, may present with very similar clinical symptoms at birth, and the Tzanck test or biopsy may be required for differential diagnosis.
一名男婴出生时头皮和前额出现多个脓疱、糜烂及红斑。出生一周后，新的脓疱持续出现，形成结痂的环形斑块并伴有色素沉着。对可能的病原体检测均为阴性。Tzanck涂片和皮肤活检显示，在对应毛囊的角质层下方有脓疱，其中含有嗜酸性粒细胞和中性粒细胞。综合判断，诊断为嗜酸性脓疱性毛囊炎（EPF）。头部的脓疱经局部使用皮质类固醇治疗后迅速消失，尽管出生后约一个月躯干仍有新的皮疹出现。据我们所知，迄今为止仅报道过两例出生时即患EPF的病例。在此，我们还讨论了出生时非感染性脓疱疾病的鉴别诊断，包括新生儿毒性红斑和新生儿短暂性脓疱性黑素沉着。这些疾病以及EPF在出生时可能表现出非常相似的临床症状，可能需要进行Tzanck试验或活检以进行鉴别诊断。
