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Erythema Toxicum Neonatorum — SCE Dermatology MCQ

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EasyPaediatric DermatologyErythema Toxicum NeonatorumSCE Dermatology

A 30-year-old woman presents with erythema toxicum neonatorum in her 2-day-old infant. The baby has scattered erythematous macules and papules with small central pustules on the trunk and face. He is feeding well and afebrile. What is the significance of this finding?

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Correct answer: E — Benign self-limiting condition — reassure parents; no treatment needed

Erythema toxicum neonatorum (ETN) is the most common pustular eruption of the newborn, affecting approximately 50% of term infants. It presents within the first 48-72 hours of life with erythematous macules, papules, and small pustules on the trunk, face, and proximal limbs (palms/soles are typically spared — involvement of these sites should raise suspicion for other diagnoses). Wright stain of the pustule contents shows abundant eosinophils (not neutrophils). It is completely benign and self-limiting (resolves within 5-14 days). No treatment is required. Differential diagnoses include neonatal HSV (grouped vesicles, often unwell), transient neonatal pustular melanosis, and staphylococcal infection.

Reference: BAD 2019; Paediatric Dermatology Textbook