Neonatal Nuggets Part 1: skin rashes, jaundice, lumps and bumps

Author: Richard Freeman / Editor: Gareth Lewis / Reviewer: Jason Kendall, Richard Freeman / Codes: / Published: 17/03/2021

Description:

  • Sick neonates with vesiculopustular rashes should be tested for HSV, candidal and Staphylococcal infections (EL3).
  • Infantile seborrhoeic dermatitis usually responds to conservative management (EL3) but resistant cases can be treated with topical antifungals (EL2-).
  • Neonates with hyperbilirubinaemia should receive phototherapy based upon comparison of serum levels to the NICE treatment threshold graphs (EL4).
  • Phototherapy is effective treatment for pathological hyperbilirubaemia in term and preterm neonates (EL1 to EL1++).
  • Most cases of neonatal diastasis recti, umbilical hernia, communicating hydrocoele and unilateral undescended testicle will resolve spontaneously without treatment (EL3).
  • There is evidence that application of salt is effective in treating umbilical granulomas (EL2+) without the risk of silver nitrate burns (EL3).
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References:

  1. Mason JK, Laurie GT. Mason and McCall Smith’s Law and Medical Ethics. 7th edn. Oxford: Oxford University Press, 2006.
  2. Stewart MG. Evidence-based medicine in rhinology. Otolaryngology and Head and Neck Surgery 2008;16(1):14-17, February 2008.
  3. Newborn Photo Library. Stanford School of Medicine [Online]. Available from here [Accessed 28th February 2016].
  4. National Institute for Health and Care Excellence. Neonatal jaundice [CG98]. London: National Institute for Health and Care Excellence 2010.
  5. Batu ED, Yeni S, Teksam O. The factor affecting neonatal presentations to the pediatric emergency department. J Emerg Med 2015;48(5):542-7.
  6. Liu C, Feng J, Qu R, et al. Epidemiologic study of the predisposing factors in erythema toxicum neonatorum. Dermatology. 2005;210(4):269272.
  7. Berg FJ, Solomon LM. Erythemaneonatorum toxicum. Arch Dis Child 1987;62:327-328.
  8. Van Praag MC, Van Rooij RW, Folkers E, Spritzer R et al. Diagnosis and treatment of pustular disorders in the neonate. Pediatr Dermatol. 1997;14(2):131143.
  9. Schachner L, Press S. Vesicular, bullous and pustular disorders in infancy and childhood. Pediatr Clin North Am. 1983;30(4):609629.
  10. Laude TA. Approach to dermatologic disorders in black children. Semin Dermatol. 1995;14(1):1520.
  11. OConnor NR, McLaughlin MR, Ham P. Newborn skin: Part 1. Common Rashes. Am Fam Physician 2008;77(1):47-52.
  12. Selimoglu MA, Dilmen U, Karakelleoglu C, Bitlisli H, Tunnessen WW. Picture of the month. Harlequin color change. Arch Pediatr Adolesc Med. 1995;149(10):11711172.
  13. Williams ML. Differential diagnosis of seborrheic dermatitis. Pediatr Rev. 1986;7(7):204211.
  14. Tollesson A, Frithz A, Stenlund K. Malassezia furfur in infantile seborrheic dermatitis. Pediatr Dermatol. 1997;14(6):423425.
  15. Janniger CK. Infantile seborrheic dermatitis: an approach to cradle cap. Cutis. 1993;51(4):233235.
  16. Clinical Knowledge Summaries: seborrhoeic dermatitis (revised February 2013). Clinical Knowledge Summaries National Institute for Heath and Care Excellence [Online]. Available from here [Accessed 23rd February 2016].
  17. National Institute for Health and Care Excellence. Neonatal jaundice [CG98]. London: National Institute for Health and Care Excellence 2010.
  18. National Institute of Child Health and Human Development randomized, controlled trials of phototherapy for neonatal hyperbilirubinemia. Pediatrics 1985; 75:(2 Pt 2)385-441.
  19. Sisson TR, Kendall N, Glauser SC et al. Phototherapy of jaundice in newborn infant. I. ABO blood group incompatibility. Journal of Pediatrics 1971;79:(6)904-10.
  20. Lewis HM, Campbell RH, Hambleton G. Use or abuse of phototherapy for physiological jaundice of newborn infants. Lancet 1982;2(8295)408-10.
  21. Meloni T, Costa S, Dore A et al. Phototherapy for neonatal hyperbilirubinemia in mature newborn infants with erythrocyte G-6- PD deficiency. Journal of Pediatrics 1974;85:(4)560-2.
  22. Martinez JC, Maisels MJ, Otheguy L et al. Hyperbilirubinemia in the breast-fed newborn: A controlled trial of four interventions. Pediatrics 1993;91:(2)470-3.
  23. Ju SH and Lin CH. The effect of moderate non-hemolytic jaundice and phototherapy on newborn behavior. Chung-Hua Min Kuo Hsiao Erh Ko i Hsueh Hui Tsa Chih 1991;32:(1)31-41.
  24. Morris BH, Oh W, Tyson JE et al. Aggressive vs. conservative phototherapy for infants with extremely low birth weight. New England Journal of Medicine 2008;359:(18)1885-96.
  25. Valdes OS, Maurer HM, Shumway CN et al. Controlled clinical trial of phenobarbital and-or light in reducing neonatal hyperbilirubinemia in a predominantly Negro population. Journal of Pediatrics 1971;79:(6)1015-7.
  26. Maurer HM, Shumway CN, Draper DA et al. Controlled trial comparing agar, intermittent phototherapy, and continuous phototherapy for reducing neonatal hyperbilirubinemia. Journal of Pediatrics 1973;82:(1)73-6.
  27. Wu PY, Lim RC, Hodgman JE et al. Effect of phototherapy in preterm infants on growth in the neonatal period. Journal of Pediatrics 1974;85:(4)563-6.
  28. Curtis-Cohen M, Stahl GE, Costarino AT et al. Randomized trial of prophylactic phototherapy in the infant with very low birth weight. Journal of Pediatrics 1985;107:(1)121-4.
  29. Disorders of the umbilicus in infants and children: A consensus statement of the Canadian Association of Paediatric Surgeons. Paediatrics and Child Health 2001;6(6):312-313.
  30. ODonnell KA, Glick PL, Caty MG. Pediatric umbilical problems. Pediatr Clin North Am 1998;45:7919.
  31. Skinner MA, Grosfeld JL. Inguinal and umbilical hernia repair in infants and children. Surg Clin North Am 1993;73:43949.
  32. Naji H, Ingolfsson I, Isacson D, Svensson JF. Decision making in the management of hydroceles in infants and children. Eur J Pediatr 2012;171(5):807-10.
  33. Docimo SG, Silver RI, Cromie W. The undescended testicle: diagnosis and management. Am Fam Physician 2000;62(9):2037-44, 2074-8.
  34. Berkowitz GS, Lapinski RH, Dolgin SE, Gazella JG, Bodian CA, Holzman IR. Prevalence and natural history of cryptorchidism. Pediatrics 1993;92:449.
  35. Chamberlain JM, Gorman RL, Young GM. Silver nitrate burns following treatment for umbilical granuloma. Pediatr emerg care 1992;8(1):29-30.
  36. Kesaree N, Babu PS, Banapurmath CR, Krishnamurthy SN. Umbilical granuloma. Indian Pediatrics 1983;20(9):690-2.

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