Neonate assessment - Integumentary/skin - Normal findings

Pink with acrocyanosis

hands and feet are blue - response to cold environment -immature peripheral circulation

Lanugo

fine, downy hair that develops after 16 weeks of gestation, the amount of lanugo decreases as etus ages, often seen on the neonate's back/shoulders/forehead - gradually falls out - presence/ amount of lanugo assist in estimating gestational age - abundant lanugo may be sign of prematurity/genetic disorder

Mongolian spots

flat, bluish discolored area on the lower back/buttock, seen more often in African American, Asian, Hispanics, and Native Americans - might be mistaken for bruising - need to document size and location - resolves on own by school age

stork bites

found at nape of the neck, on the eyelid, between the eyes, or on the upper lip. They deepen in color when neonate cries. They disappear within the 1st year of life

Vernix caseosa

protective substance secreted from sebaceous glands that covered the fetus during pregnancy, it looks like a whitish cheesy substance, may be noted in axillary areas and genital areas of full-term neonates - presence/amount of vernix assists in estimating gestational age - full-term neonates usually have none/small small amounts of vernix

Nervous flammeus

purple - red colored flat areas that can be located on various portions of the body. They do not disappear

Strawberry toxicum

raised with red lesions that develop duirng neonatal period. They spontaneously resolve during early childhood

Erythema toxicum

rash with red macules and papules (white to yellowish- white papule in center surrounded by reddened skin) that appears in different areas on the body, usually the trunk area, can appear within 24 hrs of birth and up to 2 weeks - benign - disappears without treatment

Mila

white papules on face, more frequently seen on the bridge of the nose/chin - exposed sebaceous glands that resolve without treatment - parents might mistake these for "white heads" -inform parents to leave them alone and let them resolve on their own