Erythema Toxicum Neonatorum

Aka: Erythema Toxicum Neonatorum, Erythema Toxicum

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II. Epidemiology

  1. Incidence: 30-70% of all infants
  2. More common in term infants (birth weight >2500 grams)
  3. Most common pustular dermatitis in newborns

III. Symptoms

  1. Newborn Rash with flea-bitten appearance
  2. Occurs 24 hours to 2 weeks after birth
    1. Typically onset in first 4 days of life, but not present at birth
  3. Lesions fade in 1 week (may recur in first few weeks of life)
    1. Typically resolves after 4 days

IV. Signs

  1. Flea-Bitten Appearance
    1. Small white Pustules on red base
  2. Characteristics
    1. Follicular, yellowish-hued, papulovesicular lesions
    2. Starts as Macule or Papule
    3. Develops Pustules later
    4. Lesions sorrounded by irregular, large red base
  3. Size: Lesions are 1 to 3 mm in diameter
  4. Lesions are NOT grouped
    1. Contrast the grouped lesions in Neonatal HSV
  5. Distribution
    1. Involved areas: Face, trunk, and proximal arms, and legs
    2. Spared areas: Palms and soles
  6. No associated organ involvement
    1. Contrast with Neonatal HSV (e.g. Hepatomegaly)

V. Labs

  1. Vesicles contain Eosinophils on Gram Stain or wright stain
  2. Negative culture
  3. Complete Blood Count
    1. Differential with increased Eosinophils

VI. Differential Diagnosis

  1. See Neonatal Pustules and Vessicles
  2. Neonatal HSV

VII. Associated Conditions

  1. Transient Neonatal Pustular Melanosis
    1. Similar condition seen in children with darker complexion
    2. Pustules without surrounding erythema

VIII. Management

  1. No management needed for this benign dermatitis
  2. Resolves spontaneously in 1 to 2 weeks without scarring

IX. References

  1. Claudius and Behar in Herbert (2020) EM:Rap 20(8): 5-7
  2. Liu (2005) Dermatology 210:269-72 [PubMed]
  3. Snyder (2024) Am Fam Physician 109(3): 212-6 [PubMed]

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Related Studies

Ontology: Erythema toxicum neonatorum (C0263324)

Concepts Disease or Syndrome (T047)
ICD10 P83.1
SnomedCT 32698008, 206550006, 206555001, 240302002
English Erythema toxicum, Erythema toxicum neonatorum, ETN - Erythema toxi neonatorum, erythema toxicum of newborn (diagnosis), erythema toxicum of newborn, erythema neonatorum, erythema neonatorum toxicum, erythema toxicum, erythema toxicum neonatorum, Erythema toxicum neonatorum (disorder), Toxic erythema of the newborn (disorder), Erythroderma neonatorum, Erythroderma neonatorum (disorder), erythema; neonatorum, toxic, erythema; neonatorum, erythema; toxic, toxic, newborn, erythroderma; neonatorum, neonatorum; erythema, neonatorum; erythroderma, Toxic erythema of newborn, Erythema neonatorum, Neonatal erythema toxicum, Toxic erythema of the newborn, ETN - Erythema toxicum neonatorum
Italian Eritema tossico del neonato
Japanese 新生児中毒性紅斑, ｼﾝｾｲｼﾞﾁｭｳﾄﾞｸｾｲｺｳﾊﾝ
Czech Toxický erytém novorozenců
Korean 신생아 중독성 홍반
Spanish eritodermia del recién nacido, eritrodermia del recién nacido, eritodermia del recién nacido (trastorno), eritrodermia del recién nacido (trastorno), eritema tóxico del recién nacido, eritema tóxico neonatal (trastorno), Eritema tóxico del neonato, eritema tóxico neonatal, eritrodermia neonatal
Hungarian Erythema toxicum neonatorum
Dutch erytheem; neonatorum, toxicum, erytheem; neonatorum, erytheem; toxicum, toxisch, pasgeborene, erytrodermie; neonatorum, neonatorum; erytheem, neonatorum; erytrodermie, Toxisch erytheem van pasgeborene, erythema neonatorum toxicum
Portuguese Eritema tóxico do recém nascido
French Erythème toxique du nouveau-né
German Erythema toxicum neonatorum
Derived from the NIH UMLS (Unified Medical Language System)

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