Advances in pharmacotherapeutic management of common skin diseases in neonates and infants

ABSTRACT

Introduction: neonatal and infantile skin diseases are frequently encountered in the clinical practice and represent worldwide a socioeconomic issue. They encompass a wide range of acquired or congenital conditions, including infections, vascular lesions and inflammatory diseases and can present with different degrees of severity, leading in some cases to dramatic complications.

Areas covered: In this paper we report the most recent evidences on the management of some common skin diseases in neonates and infants. Hemangiomas, viral, fungal and bacterial infections, omphalitis, atopic and seborrhoeic dermatitis, napkin disease will be treated and discussed.

Expert opinion: The majority of the dermatologic alterations in neonates are physiological, transient and do not require any treatment, thus the parents can be reassured about the good prognosis. However, in some cases, serious conditions must be excluded. In particular neonatal and infantile infections should be promptly recognized and properly managed, to avoid severe complications. The therapeutic options include traditional and, although few, innovative medical treatments, which will be carefully taken into consideration by the expert Dermatologists and Paediatricians.

KEYWORDS:

• Infantile hemangiomas
• herpes simplex virus
• varicella zoster virus
• pyodermitis
• impetigo
• omphalitis
• fasciitis
• candidiasis
• diaper dermatitis
• napkin disease
• atopic dermatitis
• psoriasis
• erythroderma
• seborrhoeic dermatitis
• erythema toxicum neonatorum
• acrodermatitis enteropathica
• biotin and vitamin B6 deficiency

Article highlights

• Neonatal and infantile dermatologic diseases may be congenital or acquired, and may present with different degree of severity. Most cases resolve spontaneously, however a prompt and precise diagnosis of each condition is crucially important for the proper management of more severe diseases

• The most frequently diagnosed skin diseases encountered in the clinical practice in neonates and infants are: vascular lesions encompassing infantile hemangiomas, Candida and bacterial infections, napkin disease, atopic dermatitis and seborrhoeic dermatitis

• Infections are the leading cause of neonatal death worldwide; a prompt and precise diagnosis by the pediatrician or the dermatologist is important for the proper management of the patients and for avoiding severe or lethal complications

• Napkin disease is a major issue of pediatric dermatology. Its causes range from napkin dermatitis, to candidiasis or napkin psoriasis

• Therapeutic options encompass traditional and innovative treatments. When choosing the most adequate treatment, the clinician should evaluate risks and benefits, considering the age of the patient and the compliance of the parents, the severity of the disease, the tolerability and the contraindication of each option.

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.