A Study of Erythema Toxicum Neonatorum and Its Predisposing Factors

Erythema toxicum neonatorum is one of the commonest skin lesions observed in neonates. Despite this lesion being common, its etiology and predisposing factors remains elusive. This study was designed to evaluate various neonatal and maternal factors which predisposes to the development of erythema toxicum neonatorum. A cross-sectional case control study was conducted in Manipal Teaching Hospital, Pokhara, Nepal, where 200 newborns with erythema toxicum neonatorum and 200 newborns as controls were sampled for neonatal and maternal variables which may predispose to erythema toxicum neonatorum. Neonatal variables studied were: gender, birth weight, gestation, mode of delivery, whether the baby was born through meconium stained amniotic fluid and if the newborn had received a bath after delivery. Maternal variables studied were: parity, maternal smoking and history of atopy in the mother. Odds ratio and 95% confidence interval (CI) were used to calculate the odds and risks of developing erythema toxicum neonatorum. Higher odds of developing ETN was observed in neonates weighing more than 2500 grams [OR= 3.58; 95% CI (1.92; 6.67)], term gestation [OR= 4.03; 95% CI (1.94; 8.39)], and those neonates born through meconium stained amniotic fluid [OR= 6.882; 95% CI (1.53; 30.91)]. A number of studies have shown a significant relationship between normal birth weight and term neonates as predisposing factors in the development of erythema toxicum neonatorum. However, what our study adds is that there was a higher risk of acquiring erythema toxicum neonatorum in babies born through meconium stained amniotic fluid.