Pediatric Erythema Toxicum Follow-up
- Author: Elizabeth Arrington, MD; Chief Editor: Dirk M Elston, MD more...
Further Outpatient Care
Erythema toxicum neonatorum (ETN) is a self-limited condition that typically resolves within 2 weeks after birth. If the condition persists or does not follow the usual course, prompt consultation with a specialist is advised.
No complications or sequelae are noted with this eruption. Because of the presence of eosinophils within the lesions, investigators suspect an association with atopic disease; however, studies examining these potential links to atopy have not demonstrated any clear association.
The prognosis is excellent. The lesions typically resolve within 2 weeks, and no cutaneous or systemic sequelae are generally observed.
Parents with older children often are not concerned by the appearance of erythema toxicum neonatorum, but first-time parents should be informed in the perinatal period that an evanescent rash is likely to appear within the first 2 weeks of life. They should be reassured regarding the benign, self-limited, asymptomatic nature of this and other eruptions.
Review the clinical features with parents before they go home. If any concerns arise about an atypical rash, they should be comfortable contacting their primary care physician to discuss the issues. Before discharge, appropriately screen neonates who have risk factors for sepsis or neonatal herpes simplex virus infection.
Kanada KN, Merin MR, Munden A, Friedlander SF. A Prospective Study of Cutaneous Findings in Newborns in the United States: Correlation with Race, Ethnicity, and Gestational Status Using Updated Classification and Nomenclature. J Pediatr. 2012 Apr 10. [Medline].
Lehndorff H. Bartholomaeus Metlinger. A fifteenth century pediatrician. Arch Pediatr. 1951 Jul. 68(7):322-33. [Medline].
Eitzman DV, Smith RT. The nonspecific inflammatory cycle in the neonatal infant. AMA J Dis Child. 1959 Mar. 97(3):326-34. [Medline].
Bassukas ID. Is erythema toxicum neonatorum a mild self-limited acute cutaneous graft-versus-host-reaction from maternal-to-fetal lymphocyte transfer?. Med Hypotheses. 1992. 38:334-338. [Medline].
Haveri FT, Inamadar AC. A cross-sectional prospective study of cutaneous lesions in newborn. ISRN Dermatol. 2014. 2014:360590. [Medline].
Carr JA, Hodgman JE, Freedman RI, Levan NE. Relationship between toxic erythema and infant maturity. Am J Dis Child. 1966 Aug. 112(2):129-34. [Medline].
Keitel HG, Yadav V. Etiology of Toxic Erythema. Erythema Toxicum Neonatorum. Am J Dis Child. 1963 Sep. 106:306-9. [Medline].
Saracli T, Kenney JA Jr, Scott RB. Common skin disorders in the newborn Negro infant. Observations based on the examination of 1,000 babies. J Pediatr. 1963 Mar. 62:359-62. [Medline].
Liu C, Feng J, Qu R. Epidemiologic study of the predisposing factors in erythema toxicum neonatorum. Dermatology. 2005. 210(4):269-72. [Medline].
Morgan AJ, Steen CJ, Schwartz RA, Janniger CK. Erythema toxicum neonatorum revisited. Cutis. 2009 Jan. 83(1):13-6. [Medline].
[Guideline] New York State Department of Health. Dermatologic manifestations. New York State Department of Health. 2004. [Full Text].
O'Connor NR, McLaughlin MR, Ham P. Newborn skin: Part I. Common rashes. Am Fam Physician. 2008 Jan 1. 77(1):47-52. [Medline].
Duperrat B, Bret AJ. Erythema neonatorum allergicum. Br J Dermatol. 1961 Aug-Sep. 73:300-2. [Medline].
Hurwitz S. Erythema toxicum. In: Clinical Pediatric Dermatology. 1993: 13-14.
Johnson BL, Honig PJ, Jaworsky C. Erythema toxicum neonatorum. In: Pediatric Dermatopathology. 1994: 82.
Marchini G, Nelson A, Edner J, et al. Erythema toxicum neonatorum is an innate immune response to commensal microbes penetrated into the skin of the newborn infant. Pediatr Res. 2005 Sep. 58(3):613-6. [Medline].
Marchini G, Stabi B, Kankes K, et al. AQP1 and AQP3, psoriasin, and nitric oxide synthases 1-3 are inflammatory mediators in erythema toxicum neonatorum. Pediatr Dermatol. 2003 Sep-Oct. 20(5):377-84. [Medline].
Stone OJ. High viscosity of newborn extracellular matrix is the etiology of erythema toxicum neonatorum: neonatal jaundice?: hyaline membrane disease?. Med Hypotheses. 1990 Sep. 33(1):15-7. [Medline].
Taylor WB, Bondurant CP Jr. Erythema neonatorum allergicum; a study of the incidence in two hundred newborn infants and a review of the literature. AMA Arch Derm. 1957 Nov. 76(5):591-4. [Medline].