Newborn Examination – Normal Variations

Skin:
– Harlequin color change
– Erythema toxicum
– Cutis marmorata
– Acrocyanosis
– Milia
– Pustular melanosis
Birthmarks:
– Salmon patch (forehead)
– Stork bite (nape of neck)
– Port wine stain (can be part of other disease process)
– Mongolian (or slate grey) spots – go away within first year
– Strawberry mark (can develop up to several mos, gone by 8-9 yo)
– Cavernous hemangioma, typically resolve by age 12, but may need tx if cosmetic concern
Head:
– Caput crosses sutures, cephalohematoma does not cross sutures, subgaleal hematomas don’t cross sutures (like Jell-O, kid is often unstable)
– Molding
– Caput succedaneum
– Overriding sutures
– Plagiocephaly
– Cephalohematoma
Eyes:
– Discordant eye movements (normal up to 6 mos)
– Pseudostrabismus
– Subconjunctival hemorrhage
– Red reflex (check both eyes at the same time)
Mouth:
– Bohn nodules
– Epstein’s pearls, retention cysts
– Natal teeth
– Ankyloglossia
Ear:
– Darwin’s tubercle  (top back of helix)
– Lop ear (top looks folded over)
– Stahl’s ear (flat-looking)
– Ear tag
– Ear pit (think about kidney abnormalities)
Extremities:
– Polydactyly
– Single palmar crease
– Clinodactyly
– Cortical thumb
– Overlapping toes
– Club foot (talipes equinovarus)
– Calcaneovalgus (hyperdorsiflexion)
– Syndactyly
– from lecture by Shannon Murphy, MD
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