Skin nontumor

Vesiculobullous and acantholytic reaction patterns

Erythema toxicum neonatorum

Topic Completed: 1 July 2011

Minor changes: 11 November 2020

Copyright: 2002-2021,, Inc.

PubMed Search: Erythema toxicum neonatorum

Mowafak Hamodat, M.B.Ch.B., M.Sc.
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Cite this page: Hamodat M. Erythema toxicum neonatorum. website. Accessed December 3rd, 2021.
Definition / general
  • Skin condition in 50% of newborns, with red patches on forehead, face, chest, trunk and extremities that have raised clear bumps in the center; usually resolves within a few days without treatment
Clinical features
  • Pathogenesis unknown; may be an acute graft versus host reaction, resulting from the transfer of maternal lymphocytes during delivery
  • Erythematous pustular eruption
  • Can be diagnosed clinically based on classic appearance (Am Fam Physician 2008;77:47)
Clinical images

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Red patches with raised clear central bumps

Microscopic (histologic) description
  • Early erythematous lesion: shows perivascular inflammatory cell infiltrate with conspicuous eosinophils
  • Intraepidermal pustule (subcorneal): filled with eosinophils and occasional neutrophils
Differential diagnosis
  • Incontinentia pigment: prominent eosinophilic spongiosis, not seen in erythema toxicum neonatorum
  • Miliaria rubra (heat rash): vesicles are related to sweat ducts, not hair follicles, and typically contain mononuclear cells, not eosinophils
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