Pediatric emergency medicine trisk 1324 1324
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borders frequently are “satellite” papules and pustules. At times, the infant has
concomitant oral thrush.
Infantile Acropustulosis
Infantile acropustulosis is a recurrent, self-limited, vesiculopustular disorder
affecting young children ( Fig. 69.6 ). It presents with itchy, deep-seated pustules
or vesicles on the palms and soles. Most cases occur after scabies infestation and
this condition can wax and wane for years. Scraping for scabies mites should be
performed and treatment initiated for scabies if mites are found. Therapy is
midpotency topical steroids.
FIGURE 69.1 Neonatal acne red pustules and papules are most prominent over the cheeks and
nose of some normal newborns. (Reprinted with permission from Goodheart H. A Photoguide
of Common Skin Disorders . Baltimore: Williams & Wilkins; 1999.)
VESICULAR ERUPTIONS
Neonatal Herpes Simplex Virus Infections
Neonatal herpes simplex virus infection causes significant morbidity and
mortality if not recognized and treated promptly (see Chapter 73 SepticAppearing Infant ). Neonatal HSV is most commonly acquired in the peripartum
period (85%) but can also be acquired in the postnatal period (10%) or in utero
(5%). For peripartum or postnatally acquired infections, the extent of disease can
