Original Article
A Prospective Study of Cutaneous Findings in Newborns in the United States: Correlation with Race, Ethnicity, and Gestational Status Using Updated Classification and Nomenclature

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Objective

To provide incidence data based on ethnicity, prematurity, and body site for vascular, pigmented, and other common congenital cutaneous findings; to compare these results with previously published prospective studies; and to define updated nomenclature, classification, clinical course, and prognostic factors for the pediatric practitioner to promote a better understanding of benign versus more worrisome birthmarks.

Study design

This prospective study enrolled 594 infants in San Diego, California. Cutaneous examination was performed by pediatric dermatologists in the first 48 hours of life, with subsequent longitudinal contact via telephone, and repeat evaluations if any new lesions were reported by parents. Incidence rates were calculated by ethnicity and prematurity status.

Results

The most common vascular lesion was nevus simplex (83%), followed by infantile hemangioma (4.5% by age 3 months), capillary malformation (0.3%), and rapidly involuting congenital hemangioma (0.3%). Pigmented lesions seen at birth included dermal melanocytosis (20%), congenital melanocytic nevi (2.4%), and café au lait macules (2%). Other common skin findings were erythema toxicum neonatorum (7%), milia (8%), and sebaceous gland hyperplasia (42.6%).

Conclusion

This study of congenital cutaneous lesions, using current nomenclature and data acquired by pediatric cutaneous lesion experts, provides data regarding the role of race and ethnicity in the incidence of birthmarks, and provides valid data on the prevalence of infantile hemangioma.

Section snippets

Methods

This prospective study followed 578 pregnant women through pregnancy and the postpartum period, as well as their infants for the first 9 months after birth, to determine the incidence and locations of congenital cutaneous lesions. The study was Institutional Review Board approved at four institutions: UCSD Medical Center, Rady Children's Hospital Center, the Scripps Research Institute, and Sharp Mary Birch Hospital for Women and Newborns (SMBH), all located in San Diego. Pregnant women were

Results

Of the 578 pregnant women recruited, 267 (45%) self-identified as Caucasian, 145 (25%) as Mexican-American/Puerto Rican/South-American (designated as Hispanic), 28 (4.7%) as African-American, 56 (9.4%) as Asian, and 82 (14.2%) as “other.” Those women who declined to choose an ethnic category were grouped in the “other” category. Infants were assumed to be the same ethnicity as their mothers. Only 3 women chose 2 ethnic categories simultaneously, with all 3 choosing both Caucasian and

Discussion

A number of previous prospective studies from various countries including the United States have examined the incidence of cutaneous lesions in neonates (Table II).1, 2, 3, 4, 5, 7, 8, 9, 12, 15, 16 Our present study has the advantage of being conducted by dermatologists with specific training in pediatric dermatology to identify and differentiate newborn skin lesions. We aimed to compare the incidence of birthmarks based on race/ethnicity and prematurity to provide a more comprehensive

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  • Cited by (0)

    S.F. received funding as a Skaggs Clinical Research Scholar at the Scripps Research Institute. The authors declare no conflicts of interest.

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