Treatment :

• Gentle cleansing with a soft cloth, exposure to air.

•Topical zinc oxide and petrolatum have good barrier function.

•Hydrocortisone cream 2 -3 times daily till

clinical improvement.

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APLASIA CUTIS CONGENITA

•Focal, congenital, localized absence of skin usually noted on the scalp as multiple or solitary, non-inflammatory, well-demarcated, oval or circular 1-2 cm ulcers.

•Those formed in early gestation may heal before delivery and appear as an atrophic, fibrotic scar with associated alopecia

•Defects that are more recent may present as an ulceration.

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•Aplasia cutis congenita may be associated with under lying embryologic malformations like

1.Meningomyelocele

2.Omphalocele

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BACTERIAL INFECTIONS

•IMPETIGO

•STAPHYLOCOCCAL SCALDED SKIN SYNDROME(SSSS)

•PERIPORITIS STAPHYLOGENES AND SWEAT GLAND

ABSCESSES

•OMPHALITIS

•ECTHYMA GANGRENOSUM

•NOMA NEONATORUM (CANCRUM

ORIS/ORO FACIAL GANGRENE)

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•Common skin problems seen in neonates in India.

•Bacterial colonization of the skin and mucous membranes occurs in the first few hours of life and is due to organisms from the maternal vaginal canal or the surrounding in which the baby is placed postnatally.

•By six days of age, 30% of infants are colonized by staphylococcal organisms.

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IMPETIGO

•Two clinical types of impetigo has been described, bullous impetigo and nonbullous impetigo.

•Bullous impetigo-highly contagious infection caused mostly by Staphylococcus aureus, but sometimes Streptococcus pyogens .

•Bullous impetigo -neonates.

•Bullous impetigo-caused by staphylococcal exotoxins against Desmoglein-1, which causes bullae formation.

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•Varnish coloured crust is seen.

•The Non-bullous form seen-school going children

•Caused by streptococcus pyogens but may spread to the neonates.

•Non-bullous impetigo - honey coloured crusts with over erythematous skin.

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When bullae spread, rupture, and involve large areas, infection may spread systemically, causing pneumonia, osteomyelitis, meningitis, or septicemia.

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DIAGNOSIS :

•Gram’s stain showing polymorphonuclear cells and gram positive cocci in clusters.

TREATMENT :

•Topical antibiotic - Fusidic acid, mupirocin.

•Systemic antibiotic - penicillinase-resistant antibiotic such as cephalosporin or cloxacillin.

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STAPHYLOCOCCAL SCALDED SKIN SYNDROME(SSSS)

•This is exotoxin mediated exfoliative bullous and erosive dermatoses.

•Produced by epidermolytic toxin (exfoliatin) produced

by Staphylococcus aureus, which may exist at a distant focus like the pharynx, middle ear, or conjunctiva.

.

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