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Examination abnormalities
Published in Christopher Flannigan, A Practical Guide to Managing Paediatric Problems on the Postnatal Wards, 2017
With any neonatal rash ask about when it was first noted - was it present at birth or did it develop later? Erythema toxicum tends to present within the first four days, but is rarely present at birth. 24Transient neonatal pustular melanosis is always present at birth.25
Principles of Clinical Diagnosis
Published in Susan Bayliss Mallory, Alanna Bree, Peggy Chern, Illustrated Manual of Pediatric Dermatology, 2005
Susan Bayliss Mallory, Alanna Bree, Peggy Chern
Transient neonatal pustular melanosis MiliariaStaphylococcal scalded skin syndrome
A review of disease burden and clinical management for generalized pustular psoriasis in China
Published in Expert Review of Clinical Immunology, 2022
Based on literature and our clinical experience to date, the differential diagnoses of GPP include acute generalized exanthematous pustulosis, superficial candidiasis, subcorneal pustular dermatosis, Stevens-Johnson syndrome – a severe mucocutaneous disease characterized by severe purulent conjunctivitis, severe stomatitis with extensive mucosal necrosis, and purpuric macule, and is caused by drug exposure or infections; with a pustular eruption as an unusual form of the disease [29,30], amicrobial pustulosis of the folds, pemphigus foliaceous, IgA pemphigus subcorneal pustular dermatosis type, transient neonatal pustular melanosis, acropustulosis of infancy and SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis), adding to the challenge of correctly diagnosing GPP [1,31–34]. Moreover, diagnostic criteria for GPP vary between research entities. ERASPEN criteria stipulate that a diagnosis of GPP can be confirmed only upon disease relapse >1 episode or persistence >3 months [26]. However, the Japanese Dermatological Association (JDA) guidelines state that a definitive diagnosis of GPP can be made if patients show the following four features: 1) systemic symptoms, including fever and fatigue; 2) systemic or extensive flush accompanied by multiple sterile pustules that can sometimes merge as lakes of pus; 3) neutrophilic subcorneal pustules histopathologically characterized by Kogoj’s spongiform pustules; and 4) the above clinical and histological features occur repeatedly [35]. GPP should be suspected in patients with the second and third features [35].