Dehydroepiandrosterone (DHEA) produced from the fetal adrenal gland and androgen production from neonatal testicles may also stimulate sebum production from sebaceous glands.The role of genetics is unclear but a positive family history supports association with neonatal acne.Some researchers suggest the role of Malassezia colonization causing hypersensitivity reactions in skin but this tends to be linked to neonatal cephalic pustulosis more so than neonatal acne. Diagnosis
A work up is suggested in cases of severe acneiform eruptions or with signs of growth abnormalities to rule out potential endocrine diseases, tumor formation, or gonadal development abnormalities. A referral to a pediatric endocrinologist may be warranted. Differential Diagnosis
Other causes of acneiform eruptions such as those induced by the use of topical products like creams, ointments and shampoos on the skin are often ruled out before diagnosis. Maternal medications like lithium and high dose corticosteroids may also induce formulation of pustules in newborns and can be assessed with a thorough family history. Likewise, newborns can be assessed for infection whether bacterial, fungal or viral in nature. Erythema toxicum neonatorum, neonatal cephalic pustulosis, transient neonatal pustular melanosis, folliculitis, miliaria and milia are often ruled out before diagnosis.Some experts consider neonatal cephalic pustulosis (NCP) a form of neonatal acne while others do not. NCP presents with facial papules and pustules but no comedones. NCP has been linked to Malassezia colonization, a normal yeast found on skin, but inconsistent patterns of positive colonization and NCP suggests that Malassezia hypersensitivity reactions in susceptible newborns are the cause of the acneiform eruptions rather than colonization itself.
Infantile acropustulosis  is an intensely itchy vesicopustular eruption of the hands and feet. : 205 Involvement of scabies has been suggested.infantile acropustulosis is characterized by itchy papules and vesicles that are similar to those found in scabies "mosquito like bites" but there is absence of the typical burrowing with S like burrows on the skin and can occur in small babies as opposed to scabies mostly found on children and young adults. See also
Acropustulosis
List of cutaneous conditions

References


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