3. Seborrheic
Dermatitis
Incidence peaks in the first year of life (usually in the
first 3 months) and again in adulthood
Associated with colonization by Malassezia
Primarily affects areas with numerous sebaceous
glands
Can affect the face, scalp (cradle cap), eyebrows,
retroauricular areas
Presentation: yellow, greasy scales that may be
preceded by erythematous scaly plaques
Can affect the intertriginous area and umbilicus
Presentation: confluent erythema that appears
glistening without oozing
Both presentations are asymptomatic but mild
pruritus may be present
Diagnosis is clinical and spontaneous resolution is
common
Extensive, symptomatic, or prolonged rash can be
treated with topical ketoconazole or low potency
topical corticosteroids
5. Miliaria Rubra
(heat rash)
Hot/humid environments and excess clothing
lead to sweat accumulation within the
eccrine glands and an inflammatory reaction
Presents as an erythematous, papular rash
located in the intertriginous areas (groin,
axilla, anterior neck), face, or in areas where
skin is occluded by clothing (back)
Rash is typically asymptomatic but may be
pruritic
Management includes avoidance of
overbundling, synthetic fibers, and switch to
thin clothing made of cotton
If rash is severe, it can be treated with topical
low potency corticosteroids
7. Neonatal
Cephalic
Pustulosis
Previously called ”neonatal acne” but the
name was changed because androgen
stimulation of sebaceous glands is not
involved
Presents as erythematous papules and
pustules limited to the face and scalp with
onset around age 3 weeks
The condition self resolves without
scarring within weeks to months and can
be managed with daily cleansing of the
affected area with soap and water
Severe cases can be treated with low
potency topical corticosteroids
9. Erythema
Toxicum
Neonatorum
Etiology is unclear but may be due to
innate immune response to skin bacteria
penetrating hair follicles
Presents by age 3 days in full term
neonates as poorly demarcated
erythematous macules and papules that
classically involve the trunk and proximal
extremities but may occur anywhere
except the palms and soles (no hair
follicles present). Lesions may evolve into
small firm pustules on erythematous base
Clinical diagnosis and requires no
treatment aside from reassurance because
the rash resolves spontaneously in a week
11. Infantile
Hemangioma
Benign, vascular tumor that presents within
days to weeks after birth as a bright red,
raised plaque which proliferates in infancy and
regresses during early childhood
Mostly affects girls
Simple hemangiomas can be observed with
no intervention
Periorbital hemangioma warrants oral beta
blocker therapy (propranolol causes
vasoconstriction and promotes regression)
due to risk of visual impairment
Large hemangiomas are at an increased risk of
scarring
If unresponsive to medication, cryotherapy,
laser therapy, and resection can be performed
13. Congenital
Melanocytic
Nevus
Benign proliferation of melanocyte cells
which presents during the first few months
of life
Presents as a solitary, hyperpigmented
lesion often with overlying dark, coarse
hairs
The risk of transition to melanoma
increases with increasing size; large lesions
are surgically removed to reduce risk (or
laser ablation)
A lesion greater than 20 cm is referred to
as a giant congenital melanocytic nevus
15. Congenital
Dermal
Melanocytosis
(Mongolian
Spot)
Caused by improper migration of
melanocytes from neural crest to
epidermis during fetal development
Presents as flat, gray-blue macules that are
poorly circumscribed and will fade with
time
Classically located on the lower back and
sacrum
More common among individuals of Asian
and African American descent
Important to document diagnosis because
this may resemble bruises and lead to false
suspicion of child abuse
17. Milia
Neonatorum
Tiny epidermal papules on the face and
trunk caused by the buildup of keratin and
sebaceous secretions
Diagnosis is clinical and spontaneously
resolves without scarring
19. Neonatal
Pustular
Melanosis
Etiology is unknown
Presents as pustules anywhere on the body
that may rupture, causing a dark
discoloration which fades in 3-4 weeks
More common in African American
newborns
Clinical diagnosis and no treatment is
necessary
21. Nevus
Anemicus
A vascular anomaly due to increased
sensitivity of cutaneous blood vessels to
catecholamines such as epinephrine and
norepinephrine. This increased sensitivity
leads to permanent vasoconstriction
resulting in hypopigementation
Presents as a hypopigmented patch of skin
that does not create erythema in response
to trauma, heat, or cold
Treatment is not required
23. Nevus Simplex
Also known as a macular stain, salmon
patch, or stork bite
Affects 40-60% of newborns
Present at birth most commonly on the
glabella, eyelids, and nape
Presents as a flat pink patch with indistinct
borders which is more prominent with
crying and vigorous activity
Diagnosis is clinical and no treatment is
necessary because most lesions fade
spontaneously within 1-2 years
25. Nevus
Flammeus
Also known as a port wine stain
Associated with Sturge-Weber Syndrome
Vascular malformation that is typically
unilateral and usually on the head/neck
Lesions do not regress; they grow in
proportion to the child’s growth, becoming
darker during adulthood
Can be treated with pulsed dye laser
therapy
