NEONATAL DERMATOSIS

PRESENTED BY

Dr. Ashwajit Singh1

SKIN FUNCTION IN THE NEONATE

•Normal full term infant-functional stratum corneum & fully developed barrier function.

•TEWL(transepidermal water loss)- higher in the first few days of life but rapidly improves.

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•Impaired barrier function-preterm neonate, especially <34 weeks gestation.

•Barrier function- improves rapidly after birth in the preterm infant-normal by the end of the 2/3rd week after birth.

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ECCRINE SWEATING

•Anatomically normal eccrine sweat gland-28th week of gestation

•Functionally immature in neonates born <36 weeks of gestation.

•Response usually develops in such babies by 2 weeks after birth.

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•Neonates born >36 weeks of gestation sweat in response to thermal stress from birth.

•The forehead -principal site of thermally induced sweating in the neonate.

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SEBACEOUS GLAND SECRETION

•Sebum secretion rates-high in neonates

•Stimulation of sebaceous gland activity- androgen, Dehydroepiandrosterone.

•Secretions of the fetal sebaceous glands- significant contribution to the vernix caseosa.

•Sebaceous gland activity decreases -about the end of the first month to reach a stable level by the end of the first year.

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PREVELANCE OF NEONATAL DERMATOSIS

•A cross sectional descriptive study was conducted from October 2011 to August 2013 at JSS Hospital, Mysore, involving 180 neonates and their mothers.

•Neonates were examined for cutaneous manifestations and the other variables that were analyzed are newborn sex, mode of delivery, birth weight, gestational age, and no. of pregnancies.

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•Cutaneous manifestations were observed in 90.5% of the newborns.

•Majority (77.2%) had physiological skin changes.

•Pathological skin changes were significantly higher in newborns delivered to primi, para and low birth weight neonates.

•Most common skin changes seen were milia, mongolian spots, physiological desquamation, epstein pearls, erythema neonatorum, miliaria.

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•With respect to mode of delivery, Vaginally delivered neonates showed significant association with occurrence of Milia, Epstein pearls, Physiological desquamation and Physiological hypertrichosis lanuginosa

•Neonates delivered by Caesarean section showed significant association with Erythema neonatorum and Miliaria (p<0.05).

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