Download Atlas of the Newborn [Vol 4] - A. Rudolph (BC Decker, 1997) WW PDF

TitleAtlas of the Newborn [Vol 4] - A. Rudolph (BC Decker, 1997) WW
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Total Pages167
Document Text Contents
Page 1


Atlas of the

V O L U M E 4


Page 2

V O L U M E 4


Atlas of the

Page 83

70 Dermatology and Perinatal Infection

Figure 1.205. An example of a nevus sebaceus of
Jadassohn involving the left ear.

Figure 1.206. Note the raised lesions on the face (upper
figure) and similar lesions on the left shoulder and back
(lower figure) present at birth in this infant who was other-
wise normal. Skin biopsy diagnosis was that of nevoid,
unclassified. This is a benign hamartomatous nevus in
which the skin lesions are of different cell types and vary
considerably in size and location.

Figure 1.207. Epidermolysis bullosa is an autosomally
inherited blistering and bullous disorder which is pre-
sent at birth or becomes manifest soon after birth. It
commonly affects the face, hands, feet, and variably
the limbs and trunk and is characterized by trauma-
inflicted erosions (Nikolsky’s sign) and loss of the epi-
dermis. As in this infant, the lesions are most
commonly seen over the extensor surfaces and there
are broken bullae with underlying erythroderma.
Epidermolysis bullosa occurs in three major inherited
forms: e. bullosa simplex (epidermolytic), junctional
e. bullosa (letalis; gravis), and e. bullosa dystrophica
(dominant and recessive forms) based on the presence
or absence of scarring, the mode of inheritance, and
the level of skin cleavage following minor trauma.





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Figure 1.208. In this infant with epidermolysis bullosa, pressure of the for-
ceps blade at delivery has resulted in a positive Nikolsky’s sign. In
Nikolsky’s sign, firm stroking or rubbing of the skin will cause development
of localized separation and tearing of the skin. In the Koebner phenome-
non, minimal trauma (rubbing of the skin) may result in the formation of
blebs (vesicles and bullae). Vesicles are blistering lesions less than 0.5 cm
in diameter, whereas bullae are blistering lesions 0.5 to 1 cm or more in

Figure 1.209. Bullous formation on the
lip of the same infant as in Figure 1.208
as a result of resuscitation.

Figure 1.210. In epidermolysis bullosa
simplex, an autosomal dominant condi-
tion, there is inadequate bonding
between the epidermal and dermal layers
with separation of the skin at the basal
cell and intraepidermal junction. When
the bullae break, the denuded areas
resemble second degree burns but the
ulcerated vesicles and bullae resolve
without scarring and heal rapidly.
(Sometimes in severe cases there may be
mild scarring.) Mucous membranes and
nails are usually not affected.




Neonatal Dermatology 71

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parotitis, 90
pyoderma, 88
scalded skin syndrome, 96-97

Staphylococcus aureus, 91-98

Staphylococcus epidermidis, 144

Stratum corneum, abnormalities of, 73-79

Stratum granulosum, 79

Strawberry nevus, 38-40

Streptococcal infection, 88, 90, 98-100

Sturge-Weber syndrome, 41-42

Subcutaneous fat necrosis, 19-21

Sucking blisters, 14-15

Sudamina, 13

Suffusion of face, 18

Sweat glands, 13
absent, 79

Synophrys, 34, 54

Syphilis, congenital, 93, 108-17

Syphilitic pemphigus, 105, 108, 110

Tail, 26

absent, 80
effects of syphilis, 112
hypodontia, 63

Tetanus, neonatal, 106-7

Thrombocytopenia, 43, 81, 98, 105, 111, 118,
127, 136

Thrush, 139-40

Thumbs, digitalization of, 35

Tibia, bowed, 116

Tinea capitis, 137

broad, 35
hypoplastic, 77-78
unseparated, 72

Toxic epidermal necrolysis, 75, 96-97

Toxoplasma gondii, 135

Toxoplasmosis, congenital, 121, 128,

Transient bullous dermolysis, 73

Transphyseal vessels, 94

Trichophyton tonsurans, 137

Trigeminal nerve, 41

Trismus, 106

Trisomy 13, 31

Tryptophan, low, 79

Tuberous sclerosis, 51-52, 55, 80

Tumor, cardiac, 52

Turner’s syndrome, 27, 30, 47-48

Tyrosinase-positive albinism, 54

Umbilical cord, infection of (funisitis), 92

Urine analysis, 121

neonatorum, 9
pigmentosa, 61-62

Vancomycin, 92

Varicella, 32, 133

Vascular disorders, 36-51

Vasculitis, 118-19

Vasoconstriction, peripheral, 7

Vasomotor instability, 8

Ventricles, dilated, 122

Vernix caseosa, 1-5

Vesiculobullous eruptions, 70-73

Viral infections, 117-34

Vitiligo, 51-52

Waardenburg’s syndrome, 34, 54-55

Webbing of skin, 27

Wegner’s sign, 114

Wimberger’s sign, 116

Witch’s milk, 27

Xanthogranulomatosis, juvenile, 83

Xanthoma, 61

Zosteriform eruption, 123

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