Erythema toxicum

Definition

Erythema toxicum is a common skin condition seen in newborns.

Alternative Names

Erythema toxicum neonatorum; ETN; Toxic erythema of the newborn; Flea-bite dermatitis

Causes

Erythema toxicum may appear in approximately one half of all normal newborn infants. The condition may appear in the first few hours of life, or it can appear after the first day. The condition can last for several days.

Although erythema toxicum is harmless, it can be of great concern to the new parent. Its cause is unknown, but thought to be related to the immune system.

Symptoms

The main symptom is a rash of small, yellow-to-white-colored bumps (papules) surrounded by red skin. There may be a few or several papules. They are usually on the face and in the middle of the body. They can also be seen on the upper arms and thighs.

The rash can change rapidly, appearing and disappearing in different areas over hours to days.

Exams and Tests

Your baby's health care provider can often make a diagnosis during a routine exam after birth. Testing is usually not needed. A skin scraping may be done if the diagnosis is not clear.

Treatment

The large red splotches usually disappear without any treatment or changes in skin care.

Outlook (Prognosis)

The rash usually clears within 2 weeks. It is often completely gone by age 4 months.

When to Contact a Medical Professional

Discuss the condition with your baby's provider during a routine examination if you are concerned.

Gallery

The Moro reflex is a normal reflex for an infant when he or she is startled or feels like they are falling. The infant will have a startled look and the arms will fling out sideways with the palms up and the thumbs flexed. Absence of the Moro reflex in newborn infants is abnormal and may indicate an injury or disease.

References

Calonje E, Brenn T, Lazar AJ, Billings SD. Neutrophilic and eosinophilic dermatoses. In: Calonje E, Brenn T, Lazar AJ, Billings SD, eds. McKee's Pathology of the Skin. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 15.

Long KA, Martin KL. Dermatological diseases of the neonate. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 666.

Last reviewed May 31, 2022 by Elika Hoss, MD, Assistant Professor of Dermatology, Mayo Clinic, Scottsdale, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..

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