Diffuse Geometric Erosions on the Skin of a Premature Infant, Fraternal Twin Unaffected
| Autor: | Nicola E. Natsis, Victoria R. Barrio, Aislyn M. Nelson, Fred Soeprono, Wynnis L. Tom |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Pregnancy Respiratory distress business.industry Health Status Infant Newborn Varicella zoster virus Infant Infant Premature Diseases medicine.disease_cause medicine.disease Dermatology Rash Fraternal twin Pediatrics Perinatology and Child Health Twins Dizygotic Etiology medicine Humans Rupture of membranes Syphilis medicine.symptom business Infant Premature Skin |
| Zdroj: | Pediatrics In Review. 42:118-121 |
| ISSN: | 1526-3347 0191-9601 |
| DOI: | 10.1542/pir.2019-0017 |
| Popis: | 1. Nicola Natsis, MD*,†,‡ 2. Fred Soeprono, MD, JD†,‡ 3. Aislyn Nelson, MD, PhD†,‡ 4. Victoria R. Barrio, MD†,‡ 5. Wynnis L. Tom, MD†,‡ 1. *School of Medicine, University of California, San Diego, San Diego, CA 2. †Division of Pediatric and Adolescent Dermatology, Rady Children’s Hospital, San Diego, CA 3. ‡Department of Dermatology, University of California, San Diego, San Diego, CA A boy is born at 27 weeks’ gestation with generalized erosions of the skin, facial bruising, respiratory distress, hypotension, and poor tone. His fraternal twin brother is without any skin abnormalities. Their 20-year-old Gravida 2 Para 1 mother had no complications during pregnancy and no history of sexually transmitted infections. Prenatal testing from an outside hospital was negative for syphilis, chlamydia, hepatitis B, and hepatitis C. She presented in preterm labor and was treated with steroids, magnesium, and terbutaline. Cesarean delivery was performed prior to rupture of membranes, reportedly because the infants were each in the frank breech position and this twin was having decelerations on the fetal heart tracing. The newborn’s Apgar scores are 3, 5, and 7 at 1, 5, and 10 minutes. Due to his skin erosions and prematurity, he is treated with ampicillin and cefotaxime. On day 3, he is transferred to our facility for a higher level of care. His examination reveals dry, diffuse superficial erosions on the neck, trunk, and extremities (Figs 1 and 2). Many lesions are geometric, with some more linear and angulated on the arms and legs. The back has scattered adherent hemorrhagic crusts. He also has thrombocytopenia at 52,000 platelets/mcL, hyperbilirubinemia (total/direct bilirubin 5.2/2.9 mg/dL), elevated C-reactive protein to 5.9 mg/L, and hypertriglyceridemia to 133 mg/dL. His white blood cell count and differential is normal. Additional testing confirmed the diagnosis. Figure 1. A 3-day-old boy with diffuse erosions with superficial crusting, many geometric or linear. Figure 2. Left leg with diffuse erosions with superficial crusting, many geometric or linear. The differential diagnosis for this rash includes infections such as congenital candidiasis, Staphylococcus aureus , Streptococcus pyogenes , varicella zoster virus (VZV), syphilis, and herpes simplex virus (HSV) infection. Noninfectious etiologies include … |
| Databáze: | OpenAIRE |
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