Transient dermatological lesions in the newborn

Most newborns at birth or within a few hours of birth, may present some benign skin lesions, which are completely normal and transitory.

It is important that parents and family members know this information so that they do not associate these injuries with problems in the newborn.

However, there are some to which you should pay a little more attention and follow up, always avoiding behaviors that may harm the newborn's skin.

Importance of newborn skin

The skin is the body's first defense, it is made up of three well-defined layers with specific functions.

In the newborn, the skin is extremely important, mainly as a means of regulating temperature and water concentrations.

Remember that the newborn, due to its body surface, can lose water much faster.

At the same time, the skin protects the newborn from the invasion of microorganisms.

Transient dermatological lesions

It is a group of skin lesions that are transitory and benign, that is, they do not represent any danger to the newborn.

In addition, most of these injuries do not warrant treatment, but the pediatrician is tasked with examining and making differential diagnoses, with the aim of calming the parents.

Thus, some of the most frequent cutaneous lesions of the neonatal stage are.

Toxic erythema

This is the so-called "allergy" in the newborn. They are very common in the term newborn, but not in the preterm newborn.

They are papules with a diameter of 1 to 3 mm, pale or white that are located on a red base.

They usually appear between the second and third day of life and disappear after approximately 48 hours. Also, they can appear at three weeks of life.

They are generally predominantly on the trunk and respect the palms of the hands and the soles of the feet.

They are lesions without an apparent cause, as parents should not worry, because their nature is not toxic, despite the name of the skin lesion. This lesion does not need treatment, it disappears spontaneously.

On the other hand, some infectious differential diagnoses are.

• Bacterial folliculitis

• Impetigo

• Herpes

• Scabies

• Candidiasis

Milio facial

Known as millium they are small cysts that are caused by the retention of secretions from the sebaceous glands. They are more common in the full-term newborn.

These papules are whitish, have a point-like appearance and texture, with a diameter of 1 to 2 mm. They are located on the nose, chin, forehead, and cheeks.

Milio facial disappears on its own and without treatment in the third or fourth week of life.

Transient neonatal pustular melanosis

They are a vesicular-pustular skin lesion, which can appear from birth, but disappear after 24, 48 or 72 hours.

Later, when the gallbladder disappears, a dark spot may remain, which may disappear after months.

Its most common location is on the forehead, the back of the neck, and the chin. It is an injury that does not require treatment.

Echymotic mask

It is a purple spot that is located on the face, it can be accompanied by petechiae.

They are due to the rupture of the capillaries of the face, when asphyxia has occurred, secondary to the circular of the umbilical cord.

The ecchymotic mask does not have a bad prognosis, in addition, it does not need treatment.

Mongolian or Baltz spot

As its name indicates, it is a spot that usually measures between 2 and 10 cm that is located mainly in the lumbosacral region, but it can appear on the thigh.

It should be noted that the term Baltz spot is preferred to Mongolian spot, since the latter can cause confusion and be discriminatory.

Added to this, the spot is seen more in black newborns.

The etiology of the spot is due to a proliferation of melanocytes, which form a blue or gray pigment, which gives the spot its dark hue.

Additionally, the stain disappears over time in early childhood, but can persist into adulthood.

Capillary hemangioma

They are small dilations of the blood vessels in the skin. ITS appearance is like a strawberry stain, which is usually darker when the baby cries.

They are often located between the two eyebrows, the eyelids, and the back of the neck.

This neonatal dermatological lesion disappears after one year of life, although it can extend into childhood or adulthood.

Recommendations for the care of the skin of newborns

As discussed above, the skin of the neonate is different from that of the adult.

In this sense, the skin of the newborn is thin, being that of pre-term newborns thinner. Also, the different layers of the skin are not quite mature.

In this way, some recommended measures for the care of your skin are.

• Do not use soaps with alkaline pH, as it can lead to infections and irritate the skin.

Likewise, soaps to clean the newborn should be of neutral pH, do not contain any fragrance and should not be applied directly to the skin of the newborn.

In the same way, the child's skin has its own mechanisms for cleaning it, for this reason it is not necessary to shower the newborn daily.

The areas of the body that should be cleaned frequently are the hands, the ano-genital area, the mouth and the axillary and inguinal folds.

• The use of antiseptic substances is not justified, because it alters the normal microbiota, as a consequence bacterial proliferation occurs.

The most commonly used solution is alcohol, but it is an irritating substance and has unfavorable effects on the newborn's skin, such as changes in pH.

The care and cleaning of the umbilical cord should be from the first day of life.

Although alcohol irritates the skin, it is the solution of choice for cleaning the umbilical cord.

It is good to note that there are multiple studies on umbilical cord disinfection methods. It is advisable that you consult with the pediatrician to make the best decision.

conclusion

Dermatological lesions of the newborn are normal and should not cause restlessness in the parents.

The important thing is to educate parents about the care and attention that the baby's skin should receive in the first 28 days of life.

In addition to this, parents should see a doctor if another symptom is associated with the condition, since these lesions have no other sign other than skin involvement.