Possible Newborn and Infant skin variations during the first year - EI Image Gallery

1 week to 4 weeks (First 6 days in NICU): January 2019

At birth, the only signs of abnormality were two small plaques on the forehead.

Skin injuries on right arm and other limbs following use of tourniquet.

Prior to definitive diagnosis, awaiting transfer to Zurich in humidified incubator.

Management of multiple wounds with Octenisept gel and Mepilex transfer

Early hyperkeratosis on knee and lower leg

No hyperkeratosis evident on soles of feet

Wounds on face caused by Venflon on hand

Wounds on hand caused by Venflon

1 week to 4 weeks (First 6 days in NICU): January 2019

Extensive peeling, dryness, and erythema

No scaling evident. Skin on back dry, cracking in places, and some small bullae

Any attempts to remove large patches of peeling skin result in skin trauma.

Cracked and peeling skin on Left inner arm, most prominent in flexures and folds.

2 weeks later, skin much improved

Mild erythema, but skin intact on back

Much improved but recent, healing bullae

Chest, belly, arms, and face appear normal

2 months: March 2019

Reduction in erythema and bullae following naked time and no skinnies

Central small blister, external red ring a possible local reaction to Mepilex Transfer

Small cluster of water blisters on lower back, probable cause: moisture and friction

Wound 1 day after de-roofing water blister cluster on lower back

Reduction in erythema and bullae following naked time/less diaper use

Improvement seen in diaper zone following naked time/less diaper use

Formation of dense, diamond, yellow scale around the neck

Start of small, dense, yellow scale in elbow crease, and dry, flaky skin on upper arm

2 months: March 2019

Pressure points evident in the evening after 2 x 3 hours in the car seat.

Some linear scaling evident along left elbow creases

Left shoulder, posterior armpit crease, and upper flank with mild scaling

The evening after 2 x 3 hours in car seat, small blisters on buttocks and right hip

Heat and friction injury on left thigh following afternoon with SPIPED nurse*.

2 days after 6 hours in car seat, and 1 day after afternoon with SPIPED nurse, multiple wounds evident and multiplying

Multiple lesions covering hips, thighs, buttocks, groin, lower legs, and arms. Large wounds from friction, small blisters appearing spontaneously.

Advice sought.

Further wounds associated with Mepilex Transfer & Flaminal Hydro. Dressings used to cover multiple lesions, wounds appear around edge of the dressing.

3 months: April 2019

Left lower leg, large wound caused by attempts to fit tubular bandage over calf

Linear, white cornification in knee creases, & fine, round, yellow scale in thigh creases

Extensive and dense, linear, yellow cornification on whole of right arm

Erythema and dense, yellow scale in left armpit.

Sores on bottom are not typical of bullae.

Irregular edges suggest fungal infection.

Diaper bullae reduced by Oxyplastine, but increased dryness, scale & cracking

Reduction in Oxyplastine led to another fungal infection treated with Imazol cream

Reduction in large scale, cracks, and dryness achieved with Bepanthen

4 months: May 2019

Dense, round, yellow scaling on whole of right leg; thickest part on lower shin

Dense, linear, yellow scale on whole of right arm; thickest part in elbow crease

Patches of scale and erythema on posterior left thigh. Knee crease prone to blistering

Dense, round, yellow/brown scaling on both elbows (Left elbow pictured)

Fine, round, white scaling on scalp, hairline, and lateral aspects of face

Dense, diamond, yellow cornification around the “collar” of the neck

Round, yellow scaling covering the whole back with intermittent blistering/erythema.

Skin very fragile: small blisters caused by finger-point contact on lower leg

5 months: June 2019

Round, flat, yellow scale on back improved after only 3 days bi-daily Aveeno Dermexa use

Dense, linear, yellow scaling and erythema in armpit improved

Dense, linear, yellow scale in elbow crease reduced

Dryness and build-up of yellow scale on wrist creases improved

5 months: June 2019

Erythema & inflammation evident on legs 2 hours after heat intolerance episode

Inflammation, blistering and exuding wounds 7 hrs after heat intolerance episode

Raw areas beginning to heal 12 hours after removing the roof of friction blisters

Epidermis healing well 36 hours after removing the roof of friction blisters

Blistering within diaper zone and evidence of fungal infection in right hip crease

Right hip crease after 2 applications of Imazol fungicide cream

Right hip crease after 3 days of Imazol fungicide cream application 3 times daily

Erythema due to friction from car seat stroller, acquired during hospital apt.

6 months: July 2019

Appearance of face due to overheating

Erythema and inflammation on both legs 3 hours after overheating episode

12 hours after heat exposure, fluid present beneath epidermis.

24 hours after heat exposure, mild friction resulted in denuded skin.

Large blister formed under thick skin after use of Diprobase ointment on a humid day

Left elbow crease following removal of blister roof.

Rupture/Cracking of ridges between lines of cornification on left elbow crease.

Posterior thigh showing healing blister and cracking of ridges in knee crease

6 months: July 2019

Dense, fine, yellow scale around collar of neck. Cycle of build-up followed by slough.

Build-up and sloughing scale in elbow crease

Patches of scale adjacent to denuded skin caused by attempts to remove scale.

Attempts to remove thick white/yellow scale build-up on thigh results in injury.

Fluid under thickened epidermis on hips, caused by diaper friction in hot weather

Exudating wound on left hip following removal of blister roof

Increasing wound on left hip caused by moisture and friction within diaper

Bilateral hip wounds healing via daily naked time during 38 degree heat

7 months: August 2019

Widespread skin sloughing in armpit crease, and along length of arm.

Skin sloughing and patches of erythema on belly. Attempts to remove skin cause injury

Very thick and tight skin on right thigh, with cracking and redness in creases/folds

Knee crease and posterior right thigh.

Skin cracked in knee crease, and skin folds

Sloughing skin on inner arm and very dry scale in elbow crease.

Linear, silvery scale on back of left hand & wrist.

Thick, patterned, yellow scale with large fissure on left lateral neck

Very dense, and thick, patterned scale on posterior neck, focused around collar only

7 months: August 2019

Blisters on left lower leg caused by Tiger mosquito bites

Extensive skin injury cause by scratching at mosquito bites during the night

Wound 6 hrs after treatment with Mepilex Transfer & Fucidin ointment.

Wound on day 2, scratching affects more layers of dermis than blisters.

Blister on right forearm caused by Tiger mosquito bite

Excessive skin dryness causing cracks in linear scale on heals

Dense & slightly moist thickened skin/scale in right armpit. Manual removal possible.

Very thick & tight skin on right thigh, any attempts to remove cause tears/bleeding.

8 months: September 2019

Wound on left hip originating from crack in thick skin becoming moist under diaper tab

Left-posterior armpit crease showing dense, linear, white cornification

Blister injury to left ankle caused by a seam at the edge of a new stroller seat

Skin injury/erythema resulting from cracked thick skin on upper right thigh

Suspected bacterial infection on left lower leg following scratched mosquito bites

Left arm image indicating scale at elbow crease, widespread sloughing, and blisters

Left thigh with thick skin at groin crease, injury due to mosquito bite, and scratching

Right thigh with generalised sloughing and dryness, & injuries caused by scratching

Example images 2020 - 2022

Hair trapped under skin, must be removed or risk infection

Incorrect placement of skinnies led to friction wound on foot

Mosquito bite reaction

Wound caused by scratching, cause of pruritus unknown

Local reaction to influenza vaccine

Mosquito bite reaction

Leg wound from recess trip and fall

Hip wound from recess trip and fall