Newborn Skin Findings

Mongolian Spots​- slate blue, well demarcated areas of pigmentation over the buttocks and
back. These are more common among dark-skinned babies

Erythema toxicum​- small, white occasionally vesiculopustular papules on an erythematous

base develop after 1-3 days. Contains eosinophils
Usually appearing on days 2-3 of life, this rash consists of erythematous macules with central
pinpoint vesicles scattered diffusely over the entire body. They appear similar to flea bites.
These lesions are of unknown etiology but disappears within 1 week of birth

Pustular melanosis​- vesiculopustular eruption over a dark macular base around the chin, neck,
back and soles. Contains neutrophils. Seen more commonly in black infants, the rash presents
at birth as small vesiculopustules over a brown macular base, these can last for several months

Epstein Pearls​- crysts appearing on the hard palate which is composed of accumulations of
epithelial cells.

Milia​- pearly white papules seen mostly on the chins and around the cheeks. Pinhead-sized
smooth white raised areas without surrounding erythema on the nose, chin, and forehead result
from retention of sebum in the openings of the sebacious glands. Although occasionally present
at birth, milia usually appears within the first few weeks and disappears over several weeks

Neonatal acne​- open and closed comedones or inflammatory pustules and papules on the
cheeks of the baby usually after a week from delivery

Nevus Simplex​- pink macular lesions on the nape, glabella, upper eyelids or nasolabial region

Lanugo​- hair that covers the skin of preterm infants, seen on term infants around the shoulders

Vernix caseosa​- thick, white creamy material usually absent in post term infants

Cutis Marmorata​- mottling of the skin with venous prominence. Cobblestone, lacy appearance

Salmon Patch​- also called the ‘stork bite’ or ‘angel kiss’ this splotchy pink mark fades with age

Eyelid Patch​- this birthmark fades, usually within the first year of life

Cafe-au-lait spots​- these light brown pigmented lesions usually have borders and are uniform.
They are noted in more than 10% of black infants.

Acrocyanosis​- this bluish discoloration usually appears in the palms and soles. Cyanotic
congenital heart disease can present with severe acrocyanosis
Jaundice​- physiologic jaundice occurs during days 2-5 of life and progresses from head to toe
as it peaks. Extreme jaundice may signify a hemolytic process or biliary or liver disease

Miliaria rubra​- scattered vesicles on an erythematous base, usually on the face and trunk,
result from obstruction of the sweat gland ducts; this condition disappears spontaneously within
weeks