Chattogram Maa-O-Shishu Hospital Medical College Journal Volume 19, Issue 1, January 2020 Original Article
Pattern of Dermatosis Among the Admitted Neonates in A Tertiary Care Hospital
Shamsun Nahar1* Abstract Dipika Dey2 Background: Neonatal dermatosis are common in neonatal period of first twenty Ashek Elahi3 eight days. Most of which are physiological, transient and require no therapy, as Nasim Haider3 well as pathological lesions in the skin of neonates. This study was done to see the Rajat Sankar Roy Biswas4 pattern of dermatosis in neonates and to establish the correlation between various neonatal factors, maternal factors and the occurance of dermatosis and to identify them correctly to avoid concerns of parents, Gynaecologist and Pediatricians. 1 Department of Dermatology Materials and methods: A total of 1000 admitted neonates in a 4 month period in Chattogram Maa-Shishu General Hospital Chattogram, Bangladesh. neonatal ward of a tertiary care hospital were included in this study and a detailed history and dermatological examination including hair , nail and mucous membrane 2Department of Pediatrics of each neonate was carried out. Laboratory procedures were performed as Chattogram Maa-O-Shishu Hospital Medical College required. Chattogram, Bangladesh. Results: We found 300 (30%) newborns had one or more skin lesions out of 1000 3 Department of Dermatology newborns examined. Male to female ratio was 1.14:1. Most common skin changes Cox’s-Bazar Medical College Cox’s-Bazar, Bangladesh. observed was physiological scaling (50%), Acne neonatorum (13%), Erythema toxicum neonatorum (11%), Xerosis (10%), Milia (9%), Cutis marmorata (7%), 4Department of Medicine Infantile seborrhoic dermatitis (7%). Among congenital skin lesions, congenital Chattogram Maa-O-Shishu Hospital Medical College melanocytic nevus (1%) portwine stain (1%). Genodermatosis are Epidermolysis Chattogram, Bangladesh. bullosa (0.3%), Congenital icthyosiform erythroderma (0.3%). Acquired skin manifestation seen in 17% of cases. Conclusions: Neonates are prone to suffer from a different varieties of dermatosis both physiological and pathological which are unique to neonates. It is important to differentiate them from other serious skin conditions which shows the importance of a dermatologist in the neonatal unit of a hospital.
Key words: Neonate; Dermatosis; Transient; Acquired; Congenital. INTRODUCTION Skin conditions encountered in newborns that tend to resolve by 30 days of age are considered to be transient1. They are very common and many are expected in newborns. Transient neonatal disorders characterized by a variety of clinical features and a benign course2. A thorough knowledge of these condition is mandatory in *Correspondence to: order to properly differentiate between benign disorders and other important Dr. Shamsun Nahar 3 Department of Dermatology conditions such as infections or autoimmune disorders or genodermatosis . Chattogram Maa-Shishu General Hospital Skin of neonate plays an important role in transition from an aqueous to an air- Chattogram, Bangladesh. dominant environment by providing mechanical protection, assisting thermo Mobile : +88 01711 44 84 49 regulation, immune-surveillance and fluid balance4.The skin of the infant differs Email: [email protected] from that of an adult by being thinner, delicate, weaker intercellular attachments and Date of Submission : 05.09.2019 fewer sweat and sebaceous gland secretions, weaker temperature regulation. So Date of Acceptance : 10.10.2019 neonatal skin is more susceptible to severe infections5. Majority of physiological neonatal dermatosis disappear without any treatment while www.banglajol.info/index.php/CMOSHMCJ only few are pathological6.
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Cutis murmorata talangectasia 21 7% Neonatal dermatosis are classified as follows: Cradle cap 20 6% G Transient skin disorders Vernix caseosa 15 5% G Congenital disorders- birthmarks (Nevus) Genodermatosis Icthyosis 12 4% G Acquired skin disorders specific to the neonatal period Transient pustular melanosis 7 2% 7 G Iatrogenic dermatological complications . Neonatal cephalic pustulosis 7 2.33% Skin changes are affected by hereditary,race,gestational age and Mongolian spot 9 3% maternal health in addition to other external factors such as Acquired skin disease hygiene, socioeconomic status, customs, mode of delivery etc8. Candidiasis 8 2.66% Neonatal dermatosis are a very common cause of parental Diaper dermatitis 6 2% anxiety and concern pressing the need for appropriate diagnosis Neonatal varicella syndrome 1 0.9% and counseling of parents.This avoids unnecessary diagnostic Neonatal purpurafulminants 1 0.9% and therapeutic interventions9. A number of studies have been Iatrogenic reported on neonatal dermatosis but none from this region of Bruise 2 1.8% Bangladesh. So, our study is to assess the incidence and profile Erosion 2 1.8% of neonatal dermatoses and its association with various Congenital disorder and genodermatosis perinatal risk factors in a neonatal ward of a Tertiary Care Congenital melanocytic nevus 3 1% Teaching Hospital of Chattogram. Epidermolysis bullosa