ERYTHEMA TOXIC NEWBORNS (erythema toxicum neonatorum; Greek erythema redness + toxikos the employee for greasing of arrows, i.e. poisonous) — the polymorphic enanthesis appearing at newborns, as a rule, on the first week of life, independently passing within several days and which are not followed by change of the general condition of the child. The toxic erythema is one of borderline cases of the newborns reflecting process of their adaptation upon transition from an antenatal life to extra uterine. It is noted at 20 — 30% of newborns, is more often at full-term, irrespective of the weight (weight) of a body at the birth, being on breastfeeding, is more rare at receiving artificial mixes.
The toxic erythema of newborns is carried to manifestations of allergic reaction to proteins of breast milk or other nature. The pathogeny includes patokhimichesky and pathophysiological (in the absence of immunological) stages of allergic reaction (see. Allergic diseases, Allergy). At a patokhimichesky stage occur degranulation of mast cells (see) and release of biochemical active agents — mediators of allergic reactions of immediate type (see Mediators of allergic reactions). These processes proceed under the influence of nonspecific (provocative) factors — coolings, the proteins which are soaked up not split from intestines, endotoxins of primary bacterial flora of intestines.
Clinically toxic erythema is characterized by emergence of polymorphic rash usually on the first week of life, a thicket on 2 — the 3rd day. On skin erythematic, slightly plotnovaty spots are noted, it is frequent with the grayish and dark papules or bubbles in the center containing transparent serous liquid and located more often with groups on extensor surfaces of extremities around joints, on a pilar part of the head, on a breast, buttocks, is more rare on a stomach and a face. On palms, soles, mucous membranes they are absent. Rashes can be very plentiful and cover all body or, on the contrary, single. Serous liquid contains eosinophils, at crops is sterile. Within 1 — 3 days new elements can appear though mostly in 2 — 3 days rash completely disappears. The condition of children is not broken, standard temperature. At very plentiful rashes the child is uneasy, at it are observed dyspepsia (see), insignificant increase limf, nodes, moderate increase in a spleen, at a blood analysis comes to light an eosinophilia.
Treatment usually is not required, however at very plentiful rash appoint additional drink (30 — 50 ml of 5% of solution of glucose), drugs of potassium, Dimedrol in age dosages.
The forecast is favorable, rashes pass without effects.
Bibliography: Shabalov N. P. Feather
hodny (boundary) conditions of newborns, Pediatrics, No. 6, page 39, 1983;
Shamova A. G. Allergic (toxic) erythema of newborns, Vopr. okhr. mat. also it is put., t. 27, No. 10, page 73, 1982.
V. A. Tabolin.