Keller Goff Gabrielle, Stein Sarah L, Rosenblatt Adena E
Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA.
Department of Medicine and Pediatrics, Section of Dermatology, University of Chicago, Chicago, Illinois, USA.
Pediatr Dermatol. 2025 Mar-Apr;42(2):278-283. doi: 10.1111/pde.15817. Epub 2024 Nov 10.
BACKGROUND/OBJECTIVES: Miliaria pustulosa is a noninfectious, transient skin eruption of pustules overlying erythematous plaques secondary to obstruction of eccrine glands. There are very few case reports in the literature detailing miliaria pustulosa in neonates. When presenting in neonates, its similarity to life-threatening infections may cause diagnostic confusion. By differentiating this condition from similar presentations, unnecessary treatments and tests in this population may be avoided.
Retrospective review of the medical records of nine neonates presenting with a pustular eruption diagnosed as miliaria pustulosa. Patients were seen at a children's hospital in Chicago, IL, USA; cases were selected by investigator recall.
In this case series, miliaria pustulosa presents in nine neonates as clusters of eruptive pustules with resolution or significant improvement noted after an average of 2.6 days (range 1-5 days). The average age was 4.6 days (range 1-10 days old) and the average gestational age was 34.7 weeks (range 26.3-40.1 weeks). All patients had pustular outbreaks in areas occluded by swaddling, clothes, or adhesive. Seven patients had geometric lesions that were underlying sites of intravenous (IV) site adhesive or electrocardiogram (EKG) leads.
The consistent morphological features of this pustular eruption at sites of skin occlusion and the transient course in the setting of an otherwise well-appearing infant are strongly suggestive of the diagnosis of miliaria pustulosa. It is important for clinicians to be familiar with this benign presentation and to differentiate it from other neonatal pustular eruptions to minimize invasive tests and treatments in this vulnerable population.
背景/目的：脓痱是一种非感染性、短暂性的皮肤疹，表现为在红斑性斑块上出现脓疱，继发于小汗腺阻塞。文献中很少有详细描述新生儿脓痱的病例报告。当脓痱出现在新生儿身上时，其与危及生命的感染的相似性可能会导致诊断混淆。通过将这种情况与类似表现区分开来，可以避免对这一人群进行不必要的治疗和检查。
对9例被诊断为脓痱的脓疱性皮疹新生儿的病历进行回顾性分析。这些患者在美国伊利诺伊州芝加哥的一家儿童医院就诊；病例由研究者回顾选取。
在这个病例系列中，9例新生儿出现脓痱，表现为成簇的脓疱疹，平均2.6天（范围1 - 5天）后消退或显著改善。平均年龄为4.6天（范围1 - 10天），平均胎龄为34.7周（范围26.3 - 40.1周）。所有患者在被襁褓、衣物或胶布遮盖的部位出现脓疱发作。7例患者有几何形状的皮损，这些部位是静脉（IV）置管胶布或心电图（EKG）导联的放置部位。
这种脓疱性皮疹在皮肤遮盖部位的一致形态特征以及在外观良好的婴儿中的短暂病程强烈提示脓痱的诊断。临床医生熟悉这种良性表现并将其与其他新生儿脓疱性皮疹区分开来很重要，以便在这个脆弱人群中尽量减少侵入性检查和治疗。
