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Erythema toxicum — RACP Paediatrics MCQ

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EasyNeonatalErythema toxicumRACP Paediatrics

A well term newborn on day 2 has multiple erythematous papules and pustules on the trunk and proximal limbs. The pustules contain eosinophils on Wright stain. The infant is afebrile and feeding well. What is the most likely diagnosis?

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Correct answer: D — Erythema toxicum neonatorum

Erythema toxicum neonatorum (ETN) is the most common pustular eruption in newborns, occurring in up to 50% of term neonates. It presents at day 1-3 with erythematous macules, papules, and pustules (containing eosinophils on smear). It is completely benign, self-limiting, and requires no treatment. The key is to distinguish it from serious neonatal infections.

Reference: RCH Melbourne – 2023 – Neonatal Skin CPG; RACP Paediatric Curriculum – Neonatology