Cutaneous Manifestations of Newborns in Omdurman Maternity Hospital

Abstract

The neonatal skin lesions in Sudan had not been studied before. This is a cross – sectional descriptive hospital based study. A total of 602 Newborns (NB) delivered at Omdurman Maternity Hospital were examined for the presence of skin and oral lesions within 96 hours of birth to study the clinical spectrum of neonatal cutaneous lesions, from August 2007 to January 2008. Precoded questionnaire regarding perinatal, maternal, and family medical history was administered to the mother of each child, clinical examinations were recorded and laboratory investigations were used to confirm the diagnoses of certain lesions. The data were collected, stored and analyzed using x2 and Fishers exact test for statistical association. The commonest types of skin lesions in NBs were: Mongolian spots in 471 (79.5%) NBs, linea nigra in 421 (70%), epithelial pearls in 285 (47%), sebaceous hyperplasia in 197 (32.7%), milia in 107 (17.7%), salmon patch in 106 (17.6%), desquamation in 98 (16.3%), café-au-lait spots in 91 (15%), erythema toxicum neonatorum in 82 (13.6%), Lanugo in 63 (10.5%), lcterus in 42 (7%), congenital melanocytic nevi in 37 (6%), transient viii neonatal pustular melanosis in 30 (5%), supernumerary nipple in 28 (4.6%) and miliaria in 22 (3.6%) newborns. Pigmentary lesions comprised mainly birthmarks; melanocytic brown lesions (MS, CMN, CALS and LN) were the most frequently encountered clinically, this is influenced by the racial background of the study population. Desquamation was more frequent among those less than 24 hours age and post term neonates. Salmon patch was more frequent in female (24%). Pustular eruptions in the neonate can have many clinical presentations and significance. Erythema toxicum and transient neonatal pustular melanosis (18.6%) were among the frequent, benign and temporary dermatoses of NBs. Both lesions were more frequent among full term babies who were appropriate for gestational age. Skin infections were seen in 15 (2.5%) newborns, omphalitis in 11 of NBs, impetigo bullosa manifested in 2 NBs, and skin abscess in 2 newborns. One of the newborns had the severe manifestations of the harlequin fetus. ix Almost all newborns seen in their first 96 hours would show some sort of cutaneous manifestation. The majority of which are benign and transient needing reassurance.