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July 1993

Widespread Erythroderma and Desquamation in a Neonate

Author Affiliations

New England Medical Center Hosptials, Boston, Mass

Arch Dermatol. 1993;129(7):902. doi:10.1001/archderm.1993.01680280091019

REPORT OF A CASE  A 1590-g girl was born at 32 weeks' gestation to a 21-year-old Hispanic (gravida 4, para 3) who had a history of intravenous drug abuse and hepatitis B infection and no prenatal care before delivery. Her pregnancy was complicated by vaginal yeast infections during gestation. Premature labor began 1 hour before delivery with rupture of the membranes and leakage of clear, amniotic fluid. A spontaneous vaginal delivery was performed, and the infant was born floppy with no respiratory effort. Apgar score was 6/8 at 1 and 5 minutes. On initial presentation, a diffuse papular rash on an erythematous background was present on the chest, back, abdomen, buttocks, and face. No pustules were noted. The infant continued in respiratory distress and was intubated 4 hours after delivery. Intravenous ampicillin and gentamicin was begun. Initial laboratory tests showed the following values or results: leukocytes, 3.2X109/L, with 0.65 lymphocytes, 0.9 neutrophils, 0.5 band forms, 0.15 monocytes, and 0.6 eosinophils; human immunodeficiency virus, negative; and VDRL, nonreactive. No cultures were performed on the placenta or umbilical blood.

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