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Dermatology Research and Practice
Volume 2009, Article ID 320403, 10 pages
Review Article

Diagnostic Pitfalls in Newborns and Babies with Blisters and Erosions

Department of Dermatology, eb-house Austria, Paracelsus Private Medical University Salzburg, Muellner Hauptstraße 48, 5020 Salzburg, Austria

Received 6 July 2009; Accepted 27 October 2009

Academic Editor: Clay Cockerell

Copyright © 2009 Elke Nischler et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Establishing the correct diagnosis in newborns presenting with blisters and erosions is not always a straightforward process. Many different disease entities including acquired (i.e., infectious, immunobullous, traumatic) and inherited disorders have to be taken into consideration. Similarities in clinical appearance, colonization and/or superinfections of preexisting skin lesions, as well as the absence of late changes in the neonate often pose significant diagnostic challenges. In this paper we discuss by giving examples the process of making an accurate diagnosis of blistering skin diseases in the neonatal period on the basis of a diagnostic algorithm. In addition, we provide an overview of the rational use and the limitations of laboratory procedures such as microbial testing, routine light microscopy, immunofluorescence antigen mapping, transmission electron microscopy, and molecular genetic analysis.