Neonatal scars

Neonatal scars
Major points
• The number of neonatal scars is related to gestational
age and length of time spent in an intensive care unit
• Scarring can occur with amniocentesis, chorionic
villus sampling, fetal monitoring, arterial or venous
punctures, catheter insertions, heel sticks, chest
tubes, adhesives and extravasated intravenous fluids
(Figure 2.14)
• Amniocentesis scars occur in <1% of neonates
whose mothers underwent amniocentesis; risk
decreases during second trimester; scars are usually
not apparent for weeks to months after birth
• If less than 29 weeks’ gestational age at birth,
anetoderma can develop at sites of monitors and
adhesives; presents as atrophic scars on the anterior
trunk and proximal extremities
Pathogenesis
• Caused by multiple procedures performed in utero
or in the neonatal intensive care unit
Diagnosis
• Consistent clinical history
• Clinical findings
Differential diagnosis
• Congenital dimples
• Congenital sinus tracts
• Aplasia cutis congenita
• Focal dermal hypoplasia (Goltz syndrome)
Treatment
• None effective
• Red lesions (vascular component) can be treated
with vascular laser with variable results
Prognosis
• Most commonly small and inconspicuous, but can
be large with underlying fibrosis
• Can develop secondary calcified papules and
hypertrophic scars
• Puncture sites can rarely become secondarily
infected with abscess or gangrene