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DIFFERENTIAL DIAGNOSIS

The differential diagnosis of acne is vast, but age of onset, lesion morphology and location can help to narrow the options to a reasonable number (Table 37.1). During the neonatal period, acne must be differentiated from other common dermatoses. Sebaceous hyperplasia occurs in approximately 50% of healthy neonates[34]. These transient yellowish papules arise on the cheeks, nasal bridge and forehead. Miliaria rubra is also very common during the early days of life. Overheating and bundling of neonates can cause temporary obstruction of the eccrine ducts, leading to red inflammatory papules or pustules. Small, white, non-inflammatory milia often appear on the cheeks and nose of neonates, but they generally resolve within a few months. Less commonly, candidal infections are confused with neonatal acne; in the former, the inflammatory papules and pustules are usually diffusely distributed.

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A predominantly comedonal variety of acne vulgaris needs to be differentiated …