A clinical study of neonatal dermatosis

Abstract

INTRODUCTIONThe neonatal period is defined as first four weeks of extra uterine life. The skin of the newborn serves a pivotal role in transition from aqueous intra uterine environment to extra uterine terrestrial life. Neonatal skin differs in structure and function from that of adults and hence the dermatoses seen during this period differ in their clinical presentation and therapeutic requirements. The skin of neonate is thinner less hairy has, weaker inter cellular attachments, increased susceptibility to external irritants, microbial infections and decreased contact allergen reactivity.1 The appreciation of normal physiological phenomena and their differentiation from more significant cutaneous disorders of new born is critical for dermatologist in order to modify the approach for caring of new born skin during this period. Most of the studies.2-4 regarding neonatal dermatoses have focused on the first few hours or days after birth but literature regarding full neonatal period is meagre and no such study is available from this part of the country and hence this study is an attempt to provide the frame work for an effective ABSTRACT Background: The neonatal period is the first 4 weeks of extra-uterine life. Neonatal dermatology encompasses a spectrum of cutaneous disorders from benign to life threatening. The present study was undertaken to evaluate the various dermatoses and hence assess the spectrum of dermatological conditions during the neonatal period and to study the relationship of neonatal dermatoses with maturity and birth weight of the neonates. Methods: Three hundred neonates with cutaneous manifestations, attending the OPD of dermatology and Paediatrics during one year period, were studied. Neonates receiving phototherapy and those with lesions secondary to trauma were excluded. Clinical history coupled with complete general physical, systemic and dermatological examination. Results: Three hundred cases of neonatal dermatoses were included in study. Out of 300 cases, 179 (59.7%) were male babies and 121 (140.3%) were female (sex ratio 1:5), 271 (70.3%) were term babies, 27 (9%) were preterm and 2 (0.7%) were post term. Transient/non-infective cutaneous lesions were the commonest 144 (48%) followed by Infectious 68 (22.67%), eczematous disorder 33 (11%) and pigmentary dermatoses 25 (8.33). Vascular lesions and hematomas accounted for 18 (6%) while genodermatoses were seen 7 (2.33%). 5 cases of subcutaneous fat disorders were observed. Conclusions: As the spectrum of neonatal dermatology is vast, its knowledge to dermatologist is very important so as to differentiate the more common benign disorders from less frequent life-threatening dermatoses, so that timely intervention could facilitate a better therapeutic outcome.