dermatology

Question 1

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Presents as tiny nonerythematous pustules, ruptured pustules up to several millimeters in diameter with a ring of scale, and healing pustules with underlying hyperpigmentation

Answer 1

neonatal pustular melanosis

BUZZ: non erythematous
Wright staining: neutrophils
Gram stain: no organisms

Question 2

A two week old presents with pustules, crusts, or erosions clustered . Mom reports it initially appear vesicles on an erythematous base.

What is diagnosis

Answer 2

Congenital HSV
- present as localized disease with mucocutaneous lesions around 2 weeks after birth and is uncommon at the time of delivery

• Dx: Tzanck smear, direct fluorescence examination, culture, and/or polymerase chain reaction testing of the lesion
• treatment with acyclovir is indicated in affected infants.

Question 3

A term neonate presents after birth with generalized rash with tiny 2- to 4-mm erythematous macules, papules, and pustules on an erythematous base

Whats the diagnosis?

Answer 3

Congenital cutaneous candidiasis

Dx: Potassium hydroxide testing of scrapings of the skin lesion- spores and pseudohyphae of Candida albicans.
Tx: Term infants with may simply be observed, but some authors suggest treatment with topical or oral antifungal treatment.