Diagnostic Considerations

For an infant presenting with a pustular vesicular dermatitis, disease considerations may be separated into infectious and noninfectious categories. Noninfectious etiologies include erythema toxicum neonatorum, acne neonatorum, transient neonatal pustular melanosis, eosinophilic pustular folliculitis, mastocytosis, malaria neonatorum, acne neonatorum, and incontinentia pigmenti. Infectious processes to be considered include scabies, bacterial sepsis, impetigo, staphylococcal scalded skin syndrome, cutaneous candidiasis, herpes simplex infection, syphilis, and varicella infection.^[16]

Differential Diagnoses

Workup

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Minkis K, Aksentijevich I, Goldbach-Mansky R, et al. Interleukin 1 receptor antagonist deficiency presenting as infantile pustulosis mimicking infantile pustular psoriasis. Arch Dermatol. 2012 Jun. 148(6):747-52. [QxMD MEDLINE Link]. [Full Text].
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Media Gallery

Lateral and plantar aspects of the foot with a combination of intact acute vesicles and brownish hyperpigmentation of old vesicles.
Pustules on the dorsal hands of a 1-year-old child.
Scattered new and resolving pustules on the dorsal feet.

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Author

Cassondra A Ellison, MD Resident Physician, Department of Dermatology, Geisinger Medical Center

Cassondra A Ellison, MD is a member of the following medical societies: American Medical Student Association/Foundation

Disclosure: Nothing to disclose.

Coauthor(s)

Vernon J Forrester, MD Fellow, Cleveland Clinic

Disclosure: Nothing to disclose.

Nicole Lee Edmonds MD Candidate, University of Virginia School of Medicine

Disclosure: Nothing to disclose.

Barbara B Wilson, MD Edward P Cawley Associate Professor, Department of Dermatology, University of Virginia School of Medicine

Barbara B Wilson, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Medical Society of Virginia, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Van Perry, MD Assistant Professor, Department of Medicine, Division of Dermatology, University of Texas School of Medicine at San Antonio

Van Perry, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Additional Contributors

Daniel Mark Siegel, MD, MS Clinical Professor of Dermatology, Department of Dermatology, State University of New York Downstate Medical Center

Daniel Mark Siegel, MD, MS is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Association for Physician Leadership, American Society for Dermatologic Surgery, American Society for MOHS Surgery, International Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

Acknowledgements

Howard Pride, MD Associate Physician, Departments of Pediatrics and Dermatology, Geisinger Medical Center

Howard Pride is a member of the following medical societies: American Academy of Dermatology and Society for Pediatric Dermatology

Disclosure: Nothing to disclose.