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A 5 week old baby boy developed red papules and pustules on his face, most notably his cheeks.  The lesions were first noted by the parents 4 weeks after birth.

What is your diagnosis?

Diagnosis: Neonatal Cepahalic Pustulosis (aka: neonatal acne, infantile acne)

Neonatal Cepahalic Pustulosis is a harmless skin condition seen in infants from birth to approximately 8 months old. The working hypothesis is that the mother's hormones are actively and harmlessly functioning within the infant, it causes the sebaceous oil glands to clog and the acne to appear very much like in true adolescence.  Others feel that pityrosporum may also be involved in the etiology in the shorter-lived type.  Boys tend to be affected more than girls, but both get the condition.  Some cases tend to resolve rapidly without any intervention, and other cases tend to be longer lasting.  The definitive nomenclature has not been determined, but some called the shorter-lived version neonatal acne (pityrosporum?)and the longer-lived version infantile acne (maternal hormones?), both sub-types of Neonatal Cepahalic Pustulosis.

Neonatal Cepahalic Pustulosis is most commonly first noted at about week 2-4 but can occur up to 6-8 months.   Although it is harmless and most cases usually clear up in a few weeks or months.  Most parents want to treat it because of its disturbing and unsightly appearance.

In this particular case I prescribed Cleocin lotion to be applied sparingly twice daily.  I also recommended no other "read-about-online" or "grandmother, friend, or neighbor" recommended treatments. Only a gentile non-detergent cleanser (Vanicream cleansing bar) with a  cotton washcloth, as needed. Cerave lotion for moisturization, PRN.

The parents reported a significant and acceptable improvement approximately 14 days after the initiation  of treatment.

After 2 weeks treatment:

I have no financial interest in any of the products mentioned above.

For additional information on MSRA Infection see the links below.


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