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Erythema toxicum

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Overview

Erythema toxicum is a very common rash in infants. It appears in up to half of newborns carried to term, usually between day 2-5 after birth.

Presentation

The rash is composed of small pustular lesions, each on a separate reddened base.

Diagnosis

At times the appearance can raise concern that the rash could be due to herpes simplex, however the latter generally has a more clustered and vesicular appearance.

In uncertain cases, a scraping of a lesion can be done and the fluid examined under the microscope. Herpes lesions will have a positive direct fluorescent antibody test. The fluid from erythema toxicum lesions will show many eosinophils.

Physical Examination

Skin

Face
Trunk

Causes

The cause of erythema toxicum is unknown, but it is thought to be a benign condition that causes no discomfort to the infant and the rash will generally disappear spontaneously in about 2 weeks.


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