EMERGENCIES ARE frequent in neonatal medicine as the physiological fragility of the newborn induces rapid deterioration of general condition in many circumstances, including initially localized infections. In a broad sense, one could argue that the majority of cutaneous abnormalities found in a newborn requires a rapid diagnosis for adequate management and relevant parental information.

Among neonatal emergencies, a few situations imply cutaneous symptoms, either as a predominant feature or as one of the elements of a complex clinical situation. The goal of this chapter is to provide dermatologists with the clinical knowledge of the main cutaneous neonatal problems requiring rapid diagnosis or intervention.

Taking care of these babies, whatever their cutaneous problem, generally requires a hospitalization in a neonatal unit and thus involves a neonatal team. Indeed, the consequences of the initial condition as well as of the loss of the cutaneous barrier may be severe and require supportive care, which depends on neonatologists.

To facilitate the identification of these problems, we will classify them according to the clinical presentation. We must point out that, whatever the cutaneous condition, when called to see a neonate, the physician must have always in mind infection as a possible diagnosis. Infection may be the cause of the cutaneous symptoms, or appear as a complication of an initially noninfectious skin disorder.

BULLOUS ERUPTIONS

Staphylococcal Infections

Newborns are exquisitely sensitive to the infection by Staphylococcus aureus strains that produce exfoliatin because of the immaturity of the epidermal barrier and of the renal elimination of toxins.