Cutaneous Manifestations In Neonates- A One Year Cross Sectional Study In A Tertiary Care Hospital

Abstract

Skin lesions in neonatal period range from transient self limiting conditions to serious dermatoses requiring specific therapies. They can cause significant psychological distress to parents. The awareness of the fact that most of these conditions are benign and transient is important so that parents can be reassured. Since studies on neonatal dermatoses are limited, this study has been planned to know the spectrum of cutaneous lesions in neonates, both physiological and pathological. Methods All neonates less than 28 days old attending KLEs Dr. Prabhakar Kore Hospital and MRC, Belgaum were recruited into the study. Newborns admitted in the NICU were excluded from the study. A written informed consent was obtained from the mother. Study design was non randomized cross sectional study. Sample size calculation was done using the Chi square test. Analysis of data was performed by STATA 11.2 and SPSS software. An ethical committee clearance was obtained prior to the start of the study. Results 104 neonates were enrolled in the study, out of which 49 (47%) neonates were male and 55 (53%) were female. 51 (49%) neonates were born through normal vaginal delivery and 53 (51%) by caesarian section. 3 (2.88%) neonates were born preterm, 5 (4.81%) post term and 96 (92.31%) neonates were born at term. 99 (95%) had physiological changes and 5 (5%) had pathological changes. The most common physiological change observed was mongolian spot in 34 (33%) of neonates followed by erythema toxicum neonatorum (ETN) in 27 (26%) neonates and physiological desquamation in 21 (20%) . Other less common physiological skin changes observed were milia, miliaria, hypertrichosis lanuginosa, vernix caseosa and sebaceous gland hyperplasia. Pathological skin changes were observed in only five neonates, out of which one had bullous impetigo, one had birth trauma, 1 had furunculosis, 1 had intertrigo and 1 was a collodion baby. Mongolian spot was found to be more common among low birth weight (<2.5kgs) whereas ETN was more common among neonates with normal birth weight and among males. There was no statistically significant association found with other parameters like birth order and maturity of the neonate. Conclusion In this study, physiological changes were found in 99 (95.19%) and pathological changes in 5 (4.81%). Although skin changes in neonates are common, majority are benign and transient and require no treatment. The parents need to be reassured about the self limiting nature of such lesions. Less often, more serious conditions may be found where early diagnosis and prompt institution of treatment may even be life saving.