Neonatal and Infantile Acne
Acne vulgaris is a disease that typically affects teenagers but may continue into adulthood in some cases. However, acneiform eruptions can occur in the pediatric population from birth onward. Neonatal acne refers to lesions that develop in the neonatal p
- PDF / 87,182 Bytes
- 4 Pages / 439.37 x 666.14 pts Page_size
- 34 Downloads / 222 Views
Neonatal and Infantile Acne Hilary Baldwin
51.1
Introduction
Acne vulgaris is a disease that typically affects teenagers but may continue into adulthood in some cases. However, acneiform eruptions can occur in the pediatric population from birth onward. Neonatal acne refers to lesions that develop in the neonatal period, from birth through 4 weeks old. Some consider neonatal acne to be synonymous with neonatal cephalic pustulosis. Infantile acne refers to the acneiform eruption that typically presents in children between 1 month and 1 year old [1]. Making the correct diagnosis can be a challenge, and in some cases the diagnosis of infantile acne is given whenever comedones are clinically present even if the patient is a neonate.
51.2
Background
It is estimated that up to 20 % of newborns develop an acneiform eruption. Neonatal acne occurs much more frequently in boys than girls. Two main theories exist regarding the condition’s pathophysiology. First, maternal androgens are thought to stimulate sebaceous glands in neonates [2, 3]. Second, it is postulated that an increase in neonatal dehydroepiandrosterone (DHEA) stimulates the adrenal glands. There is a questionable association between neonatal acne and the development of acne later in adolescence [3]. Neonatal cephalic pustulosis (NCP) is another name given to acneiform eruptions seen in neonates. Some experts consider this a separate entity from true neonatal acne and attribute it to the presence of Malassezia yeast on the skin [4].
H. Baldwin, M.D. (*) Department of Dermatology, SUNY Downstate School of Medicine, Brooklyn, NY, USA J.A. Zeichner (ed.), Acneiform Eruptions in Dermatology: A Differential Diagnosis, DOI 10.1007/978-1-4614-8344-1_51, © Springer Science+Business Media New York 2014
371
372
H. Baldwin
In one study, pustules of the necks of 8 of 13 neonates with acne revealed M. furfur [5]. However, not all patients with the eruption have positive cultures, suggesting hypersensitivity to yeast as the causative factor rather than level of colonization itself [6–8]. Little epidemiological data is available on infantile acne, as it so uncommon. Expert opinions suggest that it occurs more commonly in boys than girls. Infantile acne usually presents between 3 and 6 months of age, but it may develop as early as immediately after birth or as late as 1 year old. While pustular lesions may be present in both NCP and infantile acne, the presence of comedonal lesions distinguishes infantile acne from the pustular lesions of neonatal acne/ NCP [6].
51.3
Clinical Presentation
Neonatal acne typically presents with pustules and erythematous papules on the cheeks, chin, and forehead (see Fig. 51.1). Lesions less commonly affect the neck, chest, or scalp. Comedones may occasionally be present as well. Most cases are mild in severity and self-limited, resolving spontaneously within 3 months [2]. NCP patients may present predominantly with pustules and inflammatory papules, but characteristically lack comedones. Infantile acne may begin in the neonatal per
Data Loading...
