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Dr. Elizabeth A. Buzney (Dermatology): A newborn girl was transferred to this hospital because of a rash that had been present at birth. The infant, who weighed 3105 g, was born by spontaneous vaginal delivery at 40 weeks' gestation to a healthy 27-year-old mother after an uncomplicated pregnancy. At birth, no meconium was present, and the Apgar score was 7 at 1 minute and 9 at 5 minutes. On examination, numerous skin lesions, described as pustules and scabs, were present on the face, trunk, arms, and legs. A Tzanck smear was reported to be positive for multinucleated giant cells. Lumbar
Differential Diagnosis
Infectious Neonatal Vesiculopustular Dermatoses
HSV
Varicella
Cytomegalovirus
Candida
Bacterial Infection
Congenital Syphilis
Noninfectious Conditions in the Neonate with Vesicles and Erosions
Nontransient Bullous Dermatoses of the Neonate
Langerhans'-Cell Histiocytosis
Dr. Mathew M. Avram's Diagnosis
Pathological Discussion
Discussion of Management
Anatomical Diagnosis
Source Information
From the Departments of Dermatology (M.M.A.), Pediatrics (V.G.), and Pathology (A.S.), Massachusetts General Hospital and Harvard Medical School.
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