Study note

Neonatal examination of skin, hair, head, and fontanel

THE CONTEXT

General examination identifies normal neonatal findings, effects of delivery, and abnormalities requiring further evaluation.

•

Assess skin thickness, color, transparency, edema, rashes, and lesions such as hemangioma. Some minor skin findings are self-limiting.

•

Assess jaundice by pressing the skin to reveal the yellow color of subcutaneous tissue.

•

Ecchymoses or petechiae may relate to birth trauma.

•

Examine the presence and texture of lanugo, the fine fetal hair that is shed later.

•

Seborrheic dermatitis may be significant during the initial months but does not require treatment.

•

Examine head size and shape, sutures, and fontanels. A small head indicates microcephaly.

•

Caput succedaneum and cephalohematoma are common findings in normal neonates. Ventouse application can cause a chignon.

•

In vertex presentation, vaginal birth can alter head shape and cause skull bones to override at the sutures.

•

A full and tense fontanel in a quiet neonate is abnormal and may indicate meningitis, hydrocephalus, or intracranial hemorrhage.

NEETx

Learn. Practise. Remember.