This document discusses various vesiculopustular and bullous lesions that can present in newborns and infants. It describes benign conditions like erythema toxicum neonatorum and transient neonatal pustular melanosis. Infectious causes including viral infections like herpes and varicella, and bacterial infections like impetigo and congenital syphilis are outlined. Hereditary disorders like epidermolysis bullosa that cause blistering are also covered. Specific lesions associated with conditions such as congenital candidiasis are detailed. The document concludes with sections on management of infections and hereditary diseases.

1. VESICULOBULLOUS AND
PUSTULAR LESION IN
NEWBORN AND ITS
APPROACH

2. VESICLE & BULLA
• A clear fluid lesion just below the epithelium
which ruptures to form an
• erosion when located in intraepidermal
• ulcer, hen located in subepidermal layer
• <5mm then it is a vesicle ,if larger than 5mm
than it is bulla

6. BENIGN VESICULO PUSTULAR LESIONS
 ERYTHEMA TOXICUM NEONATORUM
 TRANSIENT NEONATAL PUSTULAR MELANOSIS
 NEONATAL CEPHALIC PUSTULOSIS
 MILIARIA
 INFANTILE ACROPUSTULOSIS
 SUKLING BLISTERS

7. INFECTIOUS VESICULOPUSTULAR
ERUPTIONS
– Viral infection
• - Primary herpes simplex infection
• - Varicella-zoster
– Bacterial infection
• - Staphylococcal scalded skin syndrome
• - Streptococcal infection
• - Congenital syphilis
• -Impetigo
– Fungal infection
• - Neonatal candidiasis
• - Congenital candidiasis
– Infestations
• - Scabies

8. • CONGENITAL/INHERITED BULLOUS DISORDERS
– Epidermolysis bullosa
– Bullous ichthyosiform erythroderma
– Incontinentia pigmenti
– Cutaneous mastocytosis
– Langerhan cell histicytosis
– Hyper IgE Syndrome
– Congenital erythropoitic porphyria
– Hailey–Hailey disease
Autoantibody-mediated disorders
• Pemphigus vulgaris
• Pemphigus foliaceus

10. • Supportive Treatment

20. Suckling bisters
• Usually seen after the birth
• Common sites -fingers,wrist,radial aspect of
forearm,rarely foot
• Spontaneous resolution

22. INFECTIONS

23. • Bullous lesion over palms and soles is hallmark

26. Tzanck smear

36. candidiasis
• A rare condition seen at birth, due to ascending
infection from the genital tract. Candida is able
to find its way into the amniotic fluid without
prior rupture of membranes

37. Congenital cutaneous candidiasis:
presents within 12 hours of birth.
• A macular erythema that may evolve into a
papular, vesicular or pustular phase over a
period of 1–3 days, finally results in extensive
desquamation.
• Palmar and plantar pustules are regarded as
hallmark

38. Congenital systemic candidiasis:
• An invasive infection with a high mortality
• rate, especially in VLBW infants.
• At least 50% do not have a cutaneous rash.
• Presenting signs are pneumonia (most
common), meningitis, candiduria and/or
candidemia.

39. NEONATAL Candidiasis
• Diaper candidiasis
• Its a benign condition usally after 1week
• Erythematous desquamation involving folds,
• Satellite or daughter lesions scattered along
edges of large macules
• Topical ketoconazole, zinc cream and avoiding
irritation will benefits

43. Hereditary Diseases

46. Epidermolysis Bullosa
A generalized desquamating condition of the
skin & mucosa with associated scarring ,
contractures , & dental defects that occur in 3
main hereditary forms in children & one
acquired form in adults

47. Clinical Features:-
Simplex Epidermolysis Bullosa
• Skin blisters at birth, mainly induced by
friction.
• Oral involvement absent or mild.
• Teeth normal
• Site of Blister:- Basal cells
• Inheritance:- Mainly autosomal dominant

48. • Junctional epidermolysis bullosa
• Lethal form results in extensive skin & mucosal
involvement ,
• dental abnormalities & often with death in infancy.
• The nonlethal form produces widespread skin &
variable mucosal involvement
• Intraorally large fragile heamorragic blisters of palate
• Crusted granular heamorrahagic lesions present in
perioral and perinasa

49. Dystrophic Epidermolysis Bullosa
• Dominant form is often mild.
• Recessive form is very severe with extensive
blisters & scarring of skin,
• Loss of nails
• Severe oral mucosal blistering
• scarring results in diminished
opening
• Hypoplastic teeth

50. • Epidermolysis bullosa acquisita
• Trauma or friction induced blisters
• Intraoral blisters rare
• If present, they produce scarring & diminished
oral opening

51. management
• No specific TX available
• Avoidance of trauma
• Prevention of infections
• Corticosteroids (high doses )may be tried
• Systemic use of phenytoin (Dilantin)
• Vitamin E
• Retinoids
• Dapsone
• Maintaninance of nutritional status is required in
case of restricted oral opening

66. ,TNPM

67. Eosinoplils

71. (Paraneoplastic pemphigus)
(Ebullosa acqusita)

74. Thank you