In a newborn assessment, which finding requires documentation rather than treatment?

• A. Pustular lesions requiring culture
• B. Erythema toxicum rash
• C. Patches of edema requiring antibiotics
• D. Crusted scabs requiring antiviral therapy

Answer: (B)

This question tests the ability to recognize benign, self-limiting newborn skin findings that need only documentation and reassurance versus those that require treatment. Erythema toxicum rash is a common, harmless newborn eruption that appears in the first days of life. It consists of small red patches with central yellow-white vesicles and most often shows up on the face, trunk, and limbs. It typically resolves on its own within a week or two, with no intervention needed. Because there’s no risk to the infant and no treatment is required, the appropriate action is to document the finding and reassure the family.

In contrast, findings described as pustular lesions would prompt culture and evaluation for infection, since an infectious process could require antibiotics. Edematous patches that need antibiotics suggest a bacterial skin infection rather than a benign newborn rash. Crusted scabs that require antiviral therapy raise concern for possible HSV or other viral infections, which would warrant antiviral treatment and closer monitoring.