A 20-day-old newborn was first observed due to the presence of erythematous, papular
and pustular lesions of the face: the identification of a spaghetti and meatballs finding
on fresh mycological examination of the pus led to diagnose neonatal cephalic pustulosis.
According to some Authors the latter is a disease in its own right, while others classify this
disorder as neonatal acne.
Key words Rash; neonatal cephalic pustulosis; malassezia species; neonatal acne.
ccording to some Authors neonatal cephalic pustulosis should be differentiated from neonatal acne and considered a
disease in its own right. A 20-day-old newborn
with erythematous, papular and pustular lesions
of the face was reported: the identification of a
spaghetti and meatballs finding on fresh mycological examination of the pus led to diagnose
neonatal cephalic pustulosis.
Case report
A 20-day-old, full-term, otherwise healthy
male neonate was brought by his anxious parents with an asymptomatic rash on the face for
the last 5 days. There were no other cutaneous
or systemic complaints. The neonate was delivered vaginally and weighed 2,400 g at birth. The
child was healthy and unperturbed by the rash,
having a sound sleep, while being photographed.
On mucocutaneous examination, the rash consisted of erythematous papules and pustules on the
cheeks and adjacent temporal regions bilaterally
(Fig. 1).
Discussion
After birth, the neonatal skin is known to be
gradually colonized during first few months by
the fungi of Malassezia species (1). This phenomenon is caused by the increased activity of
neonatal sebaceous glands, which are stimulated
by androgens from the testes in males and the
adrenal cortex in females. At present, it has been
widely accepted that fungi of Malassezia species,
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Kansal
Address to:
Naveen Kumar Kansal, MD
Assistant Professor
Department of Dermatology and Venereology
Government Medical College Haldwani
263139, Nainital, India
e-mail: kansalnaveen@gmail.com
References
1) Ayhan M., Sancak B., Karaduman A. et Al. - Colonization of neonate skin by Malassezia species: relationship with neonatal cephalic pustulosis. J. Am. Acad.
Dermatol. 57, 1012-8, 2007.
2) Bardazzi F., Patrizi A. - Transient cephalic neonatal
pustulosis. Arch. Dermatol. 133, 528-30, 1997.
3) Bernier V., Weill F.X., Hirigoyen V. et Al. - Skin colonisation by Malassezia species in neonates: a prospective study and relationship with neonatal cephalic
pustulosis (neonatal acne). Arch. Dermatol. 138, 2158, 2002.
4) Melnik B.C. - Acne. In: Irvine A., Hoeger P., Yan A.,
eds. - Harpers Textbook of Pediatric Dermatology.
3rd ed., vol. 1. Willey-Blackwell, Oxford 2011, pp.
79.14-22.
5) Niamba P., Weill F.X., Sarlangue J. et Al. - Is common
neonatal cephalic pustulosis (neonatal acne) triggered by Malassezia sympodialis? Arch. Dermatol. 134,
995-8, 1998.
6) Rapelanoro R., Mortureux P., Couprie B. et Al. - Neonatal Malassezia furfur pustulosis. Arch. Dermatol.
132, 190-3, 1996.
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