Clinico-epidemiological study of iatrogenic cutaneous manifestations in neonates in intensive care unit in a tertiary care hospital
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20184710Keywords:
Neonatal, Iatrogenic, NICUAbstract
Background: Neonatal dermatology, by definition, encompasses the spectrum of cutaneous disorders that arise during the first four weeks of life ranging from from physiological and transient to grossly pathological lesions in the skin of a neonate. The aim and objectives of the study were to determine the quantum of iatrogenic problems which can be minimized and prevented.
Methods: A total of 1000 neonates admitted in the tertiary care NICU of JJM Medical College were examined and spectrums of pathological cutaneous lesions noted.
Results: Among 1000 neonates examined, 101 had iatrogenic cutaneous conditions which were commonly seen in day one of life in 48 neonates and least in newborns between 15-21 days. Skin lesions were commonly seen in full term neonates (59), followed by preterm (39) and post term (3) neonates.Among the iatrogenic injuries needle prick injury (83), thermal burns (12) and bronze baby syndrome (11) were most commonly were noted in LBW and the normal for weight neonates. A variety of other conditions which could not be categorized into any of the above categories accounted for 5 cases. These included albinism, Waardenburg syndrome, TORCH complex and Down’s syndrome and Goltz syndrome.
Conclusions: Iatrogenic cutaneous abnormalities among neonates are under reported, with no detailed studies on these variants. Genetic, neonatal, maternal, social and geographic factors seen to influence the patterns of neonatal dermatoses. Hence, it is important for a dermatologist and paediatrician to have a thorough knowledge and to distinguish various iatrogenic manifestations and to minimize the outcomes during their stay in NICU.
References
Evans NJ, Rutter N. Development of the epidermis in the newborn. Biol Neonate. 1986;49:74-80.
Parikh DA. Neonatal skin disorders. In: Valia RG, Valia AR, editors. IADVL textbook of dermatology. 3rd ed. Mumbai: Bhalani Publishing House. 2001;1:160–70.
Basu S, Mishra K. Iatrogenic cutaneous injuries in neonates. In: Sarkar R, Inamdar AC, Palit A, editors. Advances in pediatric dermatology 2, Neonatal Dermatology. 1st ed, New Delhi: JAYPEE; 2014: 24-31.
Fontenele FC, Cardoso MVLML. Skin lesions in newborns – premature infants in the neonatal intensive care unit. Rev RENE. 2005;6:88-95.
Sardesai SR, Kornacka MK, Walas W, Ramanathan R. Iatrogenic skin injury in the neonatal intensive care unit. J Matern Fetal Neonatal Med. 2011;24(2):197-203.
Maalouf E, and Harvey D. Iatrogenic skin disorders. In: Harper J, Oranje A. Prose N,editors. Text book of paediatric dermatology. 2nd ed. London: Blackwell Sciences Ltd.; 2006: 125-135.
Cartlidge PHT, Fox PE, Rutter N. The scars of the newborn intensive care. Early Hum Dev. 1990;21:1–10.
Jain N, Rathore BS, Agarwal AK, Bhardwaj A. Cutaneous lesions in neonates admitted in a tertiary setup neonatal intensive care unit. Indian J Paediatr Dermatol. 2013;14:62-6.
Stalder JF. Skin care of the newborn. In: Harper J, Oranje P, Prose NS, editors. Text book of paediatric dermatology, 3rd ed. Edinburgh: Blackwell Sciences; 2000: 48-49.
Jennings RW, Hunt TK. Overview of postnatal wound healing. In: Adzick NS, Longaker MT (eds) Fetal Wound Healing. New York: Elsevier, 1992: 25–52.
Lancia. Ricerca skin lesion sin preterm infants in a neonatal intensive care unit. Italian J Paediatr Nurs Sci. 2015;7(4).
Franck LS, Hummel D, Connell K, Quinn D, Montgomey J. The safety and efficacy of peripheral intravenous catheters in ill neonates. Neonatal Netw. 2001;20:33-7.
