Thursday, September 22, 2016

A Sucking Blister In A 3 Day Old Baby

The picture above shows a blister on the of the hand of a 3 day old baby. This baby boy was delivered at full term to a healthy mother with no prenatal complications. Mother mentions that the baby is a vigorous feeder and seems hungry all the time. He has been sucking on his hands and wrists. The baby is otherwise asymptommatic. On examination of the lesion the underlying skin is non erythematous.

What is the most likely diagnosis?

A sucking blister

Case Discussion: The appearance and location of the bulla is consistent with a sucking blister. A solitary bulla or blister on normal-appearing skin located on the upper limbs may be present at birth from in utero sucking.
Often when presented with the affected extremity, the infant will demonstrate the sucking behavior in that location. Such blisters are often mistaken for herpes simplex, but the solitary nature and location help to establish the correct diagnosis—although there may be multiple blisters at times.
Nonetheless, a sucking blister is a diagnosis of exclusion, and other more serious diagnoses should be
ruled out by history and exam and further testing as indicated.

1 comment:

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