| Abstract: |
The development of the human skin from intrauterine to extrauterine life is a balletic interplay of maturing layers and interlocking structures. The epidermis is established in utero and replenished from a pool of stem cells which give rise to interfollicular epidermis ,hair follicles and sebaceous and sweat glands .Studies have shown that the epidermis of full-term infants morphologically indistinguishable from that of adults and it is reasonable to assume that the biological properties are similar as well , but more studies revealed that there is a difference especially in the first two days of life ..The stratum corneum of the premature neonate is thinner and markedly less effective than that of full term. These premature neonates therefore have a dysfunctional epidermal barrier and experience resultant difficulties with fluid homeostasis, thermoregulation, and infection control .Because the skin offers protection from a fluid and electrolytes imbalance, infection and temperature instability, disruption in neonatal skin integrity and function can cause significant adverse consequences for the infant.Neonatal skin plays as a host to a variety of dermatological conditions, ranging in spectrum from benign, self-limited disorders to severe life-threatening diseases. These conditions may include (but are not limited to) transient, findings related to trauma, disorders of pigmentation, infectious diseases, inflammatory conditions and genetic disorders .Skin lesions in neonates may be presented as papules, plaques, patches, pustules, vesicles, bullae, erosions, or ulcerations. Papular and vesicuopustular lesions are the most common presentations which can be the presenting feature for diaper rash, infectious and most of the transient neonatal disorders.Bullae, erosions, and ulcerations caused by several disorders as staphylococcal scalded skin syndrome, epidermolysis bullosa, bullous forms of ichthyosis, herpes simplex virus, aplasia cutis congenita, and several less common conditions . Other distinct categories of neonatal skin lesions include pigmented (i.e., melanocytic nevus, Mongolian spots, nevus of Ota, café au lait macules) and vascular (i.e., infantile hemangioma, port wine stain) birthmarks, and those presenting with erythema and scaling.Postnatal age and gestational age are important considerations in assessing skin maturity and in determining skin care practices. Premature infants suffer from significant morbidity and mortality, especially during the first week of life, when approximately two thirds of neonatal deaths occur.The proper care and hygiene of the normal mature neonatal skin are achieved by optimizing epidermal barrier integrity, including bathing and emolliation practices, preventing and managing infections and skin injury, and minimizing TEWL and heat or percutaneous absorption of toxins with particular reference to preterm infants born at less than 37 weeks gestational age and hospitalized neonates who require intensive care.
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