Neonatal Cephalic Pustulosis

Presentation

Neonatal cephalic pustulosis is a common and benign rash that appears within a few weeks following birth; usually between the 2nd and 4th week of life. It may, however, be present at birth.

The rash consists of small red, inflammatory papules and pustules. Unlike in infantile acne, comedones are NOT present. It typically occurs on the face, most commonly on the cheeks. It may be present over other areas of the face and scalp.

Evaluation

The diagnosis is made clinically. However, it can be difficult to differentiate it from miliaria rubra.

Management

No treatment is usually necessary. Spontaneous resolution without scarring commonly occurs within a few months. Treatment with a topical antifungal or mild steroid can be helpful in severe cases.

Recommended Reading

1. Reginatto, F. P., Villa, D. D., & Cestari, T. F. (2016). Benign skin disease with pustules in the newborn. Anais brasileiros de dermatologia, 91(2), 124–134. https://doi.org/10.1590/abd1806-4841.20164285

2. Su J. Common rashes in neonates. Aust Fam Physician. 2012 May;41(5):280-6. PMID: 22558617.

3. O'Connor NR, McLaughlin MR, Ham P. Newborn skin: Part I. Common rashes. Am Fam Physician. 2008 Jan 1;77(1):47-52. PMID: 18236822.

4. Niamba P, Weill FX, Sarlangue J, Labrèze C, Couprie B, Taïeh A. Is common neonatal cephalic pustulosis (neonatal acne) triggered by Malassezia sympodialis? Arch Dermatol. 1998 Aug;134(8):995-8. doi: 10.1001/archderm.134.8.995. PMID: 9722730.

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