Etiology, prevalence and clinical signs of erythema toxicum neonatorum
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20215017Keywords:
Erythema toxicum neonatorum, Risk factors, Etiology, Clinical manifestations, Cutaneous lesions, PediatricsAbstract
Evidence shows that erythema toxicum neonatorum (ETN) has been described in the literature since the 15th decade as a primarily rash in pediatric patients. Clinical studies show that the lesion of ETN is mainly characterized by the presence of minute yellowish papules and pustules that are usually surrounded by an irregular reddish wheal. It should be noted that evidence also demonstrated the pathology of these lesions is temporary and usually disappears within a few hours. In the present literature review, we discussed the etiology, prevalence, risk factors, and clinical signs of ETN based on findings from relevant research. The etiology of ETN is not clear among the different studies. However, some studies show involvement of immune and potential allergic reactions. The prevalence of the condition among infants is also remarkably variable among the relevant studies worldwide. There is also inconsistency in reporting the significance of the risk factors related to the prevalence and severity of the condition. On the other hand, the clinical signs among studies seem to be consistent and easily detected except when evaluating dark-skinned infants. Further studies are needed better to understand the etiology and epidemiology of the condition.
Metrics
References
Morgan AJ, Steen CJ, Schwartz RA, Janniger CK. Erythema toxicum neonatorum revisited. Cutis. 2009;83(1):13-6.
Dragomir C, Florescu L, Buhuş M. Erythema toxicum neonatorum. Rev Med Chir Soc Med Nat Iasi. 2006;110(4):797-800.
Reginatto FP, Muller FM, Peruzzo J, Cestari TF. Epidemiology and Predisposing Factors for Erythema Toxicum Neonatorum and Transient Neonatal Pustular: A Multicenter Study. Pediatr Dermatol. 2017;34(4):422-6.
Roques E, Ward R, Mendez MD. Erythema Toxicum. StatPearls. Treasure Island, FL: StatPearls Publish; 2020.
Marchini G, Nelson A, Edner J, Rahm S, Evers A, Hultenby K. Erythema toxicum neonatorum is an innate immune response to commensal microbes penetrated into the skin of the newborn infant. Pediatr Res. 2005;58(3):613-6.
Marchini G, Hultenby K, Nelson A, Karin E, Ståbi B, Rahm S, Ulfgren AK, Brismar H. Increased expression of HMGB-1 in the skin lesions of erythema toxicum. Pediatr Dermatol. 2007;24(5):474-82.
Marchini G, Ståbi B, Kankes K, Rahm S, Østergaard M, Nielsen S. AQP1 and AQP3, psoriasin, and nitric oxide synthases 1-3 are inflammatory mediators in erythema toxicum neonatorum. Pediatr Dermatol. 2003;20(5):377-84.
Kutlubay Z, Tanakol A, Engýn B, Onel C, Sýmsek E, Serdaroglu S, et al. Newborn Skin: Common Skin Problems. Maedica (Bucur). 2017;12(1):42-7.
Rayala BZ, Morrell DS. Common Skin Conditions in Children: Neonatal Skin Lesions. FP Essent. 2017;453:11-7.
Reddy HB, Gandra NR, Katta TP. Cutaneous Changes in Neonates in the First 72 Hours of Birth: An Observational Study. Curr Pediatr Rev. 2017;13(2):136-43.
Budair F, Aljabre S, Alquorain N, Alnafea N, Aljabre A, Alburaey A. Survey of cutaneous findings in newborns in Saudi Arabia. J Dermatol Dermatolog Surg. 2017;21(2):53-7.
Kanada KN, Merin MR, Munden A, Friedlander SF. A prospective study of cutaneous findings in newborns in the United States: correlation with race, ethnicity, and gestational status using updated classification and nomenclature. J Pediatr. 2012;161(2):240-5.
Dahiyat K. Neonatal skin lesions in Jordan, study of consecutive 500 neonates at King Hussein medical center. Calicut Med J. 2006;4(4):1.
Gokdemir G, Erdogan HK, Köşlü A, Baksu B. Cutaneous lesions in Turkish neonates born in a teaching hospital. Indian J Dermatol Venereol Leprol. 2009;75(6):638.
Almeida JR, Alchorne MM, Rozman MA. Incidence of skin conditions in neonates born at a public hospital associated with some variables in pregnant women at risk. Einstein (Sao Paulo). 2010;8(2):143-8.
Alakloby OM, Bukhari IA, Awary BH, Wunais KM. Acne neonatorum in the eastern Saudi Arabia. Indian J Dermatol Venereol Leprol. 2008;74(3):298.
Jansen T, Burgdorf WH, Plewig G. Pathogenesis and treatment of acne in childhood. Pediatr Dermatol. 1997;14(1):17-21.
Chew EW, Bingham A, Burrows D. Incidence of acne vulgaris in patients with infantile acne. Clin Exp Dermatol. 1990;15(5):376-7.
Wagner A. Distinguishing vesicular and pustular disorders in the neonate. Curr Opin Pediatr. 1997;9(4):396-405.
Bernier V, Weill FX, Hirigoyen V, Elleau C, Feyler A, Labrèze C, et al. Skin colonization by Malassezia species in neonates: a prospective study and relationship with neonatal cephalic pustulosis. Arch Dermatol. 2002;138(2):215-8.
Rapelanoro R, Mortureux P, Couprie B, Maleville J, Taïeb A. Neonatal Malassezia furfur pustulosis. Arch Dermatol. 1996;132(2):190-3.
Nguyen TM, Huan VT, Reda A, Morsy S, Nam Giang HT, Tri VD, et al. Clinical features and outcomes of neonatal dengue at the Children's Hospital 1, Ho Chi Minh, Vietnam. J Clin Virol. 2021;138:104758.
Liu C, Feng J, Qu R, Zhou H, Ma H, Niu X, et al. Epidemiologic study of the predisposing factors in erythema toxicum neonatorum. Dermatology. 2005;210(4):269-72.
Monteagudo B, Labandeira J, Cabanillas M, Acevedo A, Toribio J. Prospective study of erythema toxicum neonatorum: epidemiology and predisposing factors. Pediatr Dermatol. 2012;29(2):166-8.
Reginatto FP, Villa D, Muller FM, Peruzzo J, Peres LP, Steglich RB, et al. Prevalence and characterization of neonatal skin disorders in the first 72h of life. J Pediatr (Rio J). 2017;93(3):238-45.
Qushayri AE, Ghozy S, Reda A, Kamel AMA, Abbas AS, Dmytriw AA. The impact of Parkinson's disease on manifestations and outcomes of Covid-19 patients: A systematic review and meta-analysis. Rev Med Virol. 2021:2278.
Dibas M, Doheim MF, Ghozy S, Ros MH, Helw GO, Reda A. Incidence and survival rates and trends of skull Base chondrosarcoma: A Population-Based study. Clin Neurol Neurosurg. 2020;198:106153.
Qushayri AE, Dahy A, Reda A, Mahmoud MA, Mageed SA, Kamel AMA, et al. A closer look at the high burden of psychiatric disorders among healthcare workers in Egypt during the COVID-19 pandemic. Epidemiol Health. 2021;43:2021045.
Son PT, Reda A, Viet DC, Quynh NXT, Hung DT, Tung TH, et al. Exchange transfusion in the management of critical pertussis in young infants: a case series. Vox Sang. 2021;116(9):976-82.
Thieu H, Bach Dat B, Nam NH, Reda A, Duc NT, et al. Antibiotic resistance of Helicobacter pylori infection in a children's hospital in Vietnam: prevalence and associated factors. Minerva Med. 2020;111(5):498-501.
Reginatto FP, Villa DD, Cestari TF. Benign skin disease with pustules in the newborn. An Bras Dermatol. 2016;91(2):124-34.
Ghosh S. Neonatal pustular dermatosis: an overview. Indian J Dermatol. 2015;60(2):211.
