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No abstract

Neonatal cutaneous alterations are common, usually appearing at birth or during the first few days of life. Most of these conditions are physiological, benign, and transient, arising from a combination of immaturity of the newborn skin with environmental factors. Nonetheless, some of them may eventually be a clue to underlying disorders. Physicians should therefore be aware of these clinical manifestations so that parents can be reassured and, when necessary, complementary investigations can be undertaken.

Atualmente, com o desenvolvimento recente de agentes biológicos e outros novos fármacos, alguns dos quais com o seu uso já aprovado em idade pediátrica, torna-se importante contextualizar o papel da fototerapia na dermatologia. Esta tem um perfil de segurança excelente e bem reconhecido desde há décadas, para além de não necessitar de monitorização laboratorial, o que constitui uma mais valia, sobretudo na população pediátrica. Tem sido utilizada com sucesso nesta faixa etária no tratamento de diversas doenças dermatológicas. Neste artigo é realizada uma revisão acerca das principais particularidades da utilização da fototerapia em idade pediátrica, focando os efeitos adversos, os principais obstáculos, as suas indicações e a seleção individualizada das diferentes modalidades, de modo a facilitar a prática clínica desta terapêutica.

A 25-day-old newborn was admitted to our hospital with a diagnosis of bronchiolitis. During admission, the infant developed violaceous skin lesions with edema in inguinal and axillary regions (Figure). Lesions became ulcerated within 3 to 4 days, with infarcted necrotic areas. Blood tests showed leukopenia (white blood cell count, 2460/μL) with neutropenia (neutrophil count, 220/μL) (to convert both to ×10 9 per liter, multiply by 0.001). The lesions were biopsied and samples were sent for cultures and histopathological analysis. Intravenous floxacillin was started, followed by surgical debridement due to progression of the major lesions.His mother was addicted to drugs, she had a known hepatitis C virus infection, and the pregnancy was unsupervised. Thirteen days before delivery, she visited the emergency department with flulike symptoms. Routine infectious screening revealed negative serology for syphilis, hepatitis B virus, and human immunodeficiency virus (HIV) types 1 and 2 by enzyme-linked immunosorbent assay (ELISA). The infant was born at 40 weeks' gestation by forceps delivery.