IndianJPaediatrDermatol153150-3293223_090852
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Indian Journal of Paediatric Dermatology | Vol 15 | Issue 3 | September-December 2014 150 in our case. Aspiration cytology reveals clear serous fluid with no inflammatory cells or multinucleated giant cells. No therapy is required as this condition is self-limiting and resolves without any complications. Thirunavukkarasu Arun Babu, Vijayasankar Vijayadevagaran, Vijayan Sharmila 1 Departments of Pediatrics and 1 Obstetrics and Gynaecology, Indira Gandhi Medical College and Research Institute, Puducherry, India Sir, A term male, appropriate for gestational age baby was born to a 22-year-old G2A1 mother by spontaneous vaginal delivery. The baby was 3.4 kg, cried immediately after birth and had Apgar scores of 8 and 9 at 1 and 5 min, respectively. The neonate was found to have multiple, tiny, eruptions with clear fluid all over the body especially in the trunk and extremities. Antenatal history revealed that mother was admitted with fever at 38 + 4 weeks, 1-week before the date of delivery. She was diagnosed to have lower respiratory infection and received oral antibiotics, antipyretics, and salbutamol nebulization for 3 days following which the fever subsided. Examination of newborn revealed multiple tiny clear vesicular eruptions that closely mimicked sprinkled water droplets [Figures 1 and 2]. The lesions were about 1-3 mm size, seen predominantly over the neck, upper chest, back, and both upper limbs. The lesions were closely placed (in crops) with a shiny surface. The underlying skin was normal, without any evidence of erythema or induration. The lesions ruptured easily but healed without leaving any marks. The baby was otherwise active and feeding well. Vitals and systemic examination were normal. A diagnosis of miliaria crystallina (MC) was considered based on the morphology of the lesions. No new lesions appeared after 1 st day. The lesions disappeared spontaneously within the first 4 days of life. Miliaria crystallina is a transient, self-limiting, superficial obstruction of eccrine sweat ducts resulting in extravasation of sweat into epidermis. MC may present in the neonatal period but congenital occurrence is extremely rare. [1] This benign self-limiting condition is often triggered by hot and humid climate. The lesions contain clear watery fluid, thin-roofed, and without any inflammation. The lesions are generalized involving face, trunk and extremities but palms, soles, and mucosa are usually spared. [2] The risk factors for developing congenital MC are maternal febrile illness prior to delivery, moist occlusive environment of amniotic fluid, and vernix caseosa. [1] The presence of maternal fever was the trigger for congenital MC lesions Congenital miliaria crystallina following maternal febrile illness LETTER TO EDITOR Figure 1: Picture taken immediately after birth (note the moist and fleshy umbilical cord stump) showing distribution of vesicles involving the trunk and the upper extremities Figure 2: Tiny, clear, vesicular eruption mimicking sprinkled water droplets in upper extremity [Downloaded free from http://www.ijpd.in on Tuesday, May 03, 2016, IP: 114.121.134.5]
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Transcript of IndianJPaediatrDermatol153150-3293223_090852
Indian Journal of Paediatric Dermatology | Vol 15 | Issue 3 | September-December 2014150
in our case. Aspiration cytology reveals clear serous fluid with no inflammatory cells or multinucleated giant cells. No therapy is required as this condition is self-limiting and resolves without any complications.
Thirunavukkarasu Arun Babu, Vijayasankar Vijayadevagaran, Vijayan Sharmila1
Departments of Pediatrics and 1Obstetrics and Gynaecology, Indira Gandhi Medical College and
Research Institute, Puducherry, India
Sir,A term male, appropriate for gestational age baby was born to a 22-year-old G2A1 mother by spontaneous vaginal delivery. The baby was 3.4 kg, cried immediately after birth and had Apgar scores of 8 and 9 at 1 and 5 min, respectively. The neonate was found to have multiple, tiny, eruptions with clear fluid all over the body especially in the trunk and extremities.
Antenatal history revealed that mother was admitted with fever at 38 + 4 weeks, 1-week before the date of delivery. She was diagnosed to have lower respiratory infection and received oral antibiotics, antipyretics, and salbutamol nebulization for 3 days following which the fever subsided.
Examination of newborn revealed multiple tiny clear vesicular eruptions that closely mimicked sprinkled water droplets [Figures 1 and 2]. The lesions were about 1-3 mm size, seen predominantly over the neck, upper chest, back, and both upper limbs. The lesions were closely placed (in crops) with a shiny surface. The underlying skin was normal, without any evidence of erythema or induration. The lesions ruptured easily but healed without leaving any marks. The baby was otherwise active and feeding well. Vitals and systemic examination were normal. A diagnosis of miliaria crystallina (MC) was considered based on the morphology of the lesions. No new lesions appeared after 1st day. The lesions disappeared spontaneously within the first 4 days of life.
Miliaria crystallina is a transient, self-limiting, superficial obstruction of eccrine sweat ducts resulting in extravasation of sweat into epidermis. MC may present in the neonatal period but congenital occurrence is extremely rare.[1] This benign self-limiting condition is often triggered by hot and humid climate. The lesions contain clear watery fluid, thin-roofed, and without any inflammation. The lesions are generalized involving face, trunk and extremities but palms, soles, and mucosa are usually spared.[2] The risk factors for developing congenital MC are maternal febrile illness prior to delivery, moist occlusive environment of amniotic fluid, and vernix caseosa.[1] The presence of maternal fever was the trigger for congenital MC lesions
Congenital miliaria crystallina following maternal febrile illness
LETTER TO EDITOR
Figure 1: Picture taken immediately after birth (note the moist and fleshy umbilical cord stump) showing distribution of vesicles involving the trunk and the upper extremities
Figure 2: Tiny, clear, vesicular eruption mimicking sprinkled water droplets in upper extremity
[Downloaded free from http://www.ijpd.in on Tuesday, May 03, 2016, IP: 114.121.134.5]
Letter to Editor
Indian Journal of Paediatric Dermatology | Vol 15 | Issue 3 | September-December 2014 151
ADDRESS FOR CORRESPONDENCE Dr. Thirunavukkarasu Arun Babu,
Associate Professor of Pediatrics, Indira Gandhi Medical College and Research, Institute, Puducherry, India.
E‑mail: [email protected]
REFERENCES1. Babu TA, Sharmila V. Congenital miliaria crystallina in a
term neonate born to a mother with chorioamnionitis. Pediatr Dermatol 2012;29:306-7.
2. Taieb A, Boralevi F. Common transient neonatal dermatoses.
Access this article onlineQuick Response Code
Website: www.ijpd.in
DOI:
10.4103/2319‑7250.143679
In: Harper J, Oranje AP, Prose NS, editors. Textbook of Pediatric Dermatology. Oxford: Blackwell; 2006. p. 63-5.
[Downloaded free from http://www.ijpd.in on Tuesday, May 03, 2016, IP: 114.121.134.5]
