Advancement of dermal icterus in the jaundiced newborn.

IN NEWBORN infants, progressive hyperbilirubinemia is accompanied by a caudad advancement of dermal icterus which begins at the face and proceeds to the trunk, the extremities, and finally to the palms and soles. This clinical observation was described by Rolleston and McNee 1 in 1929, but has not been previously correlated with actual levels of serum bilirubin. In this report, the results of such an investigation on a large series of infants is presented. Our findings of a positive relationship between the concentration of serum bilirubin and the caudad progression of dermal icterus suggests that simple inspection of the skin of the newborn infant provides useful information of the actual serum bilirubin level. Materials and Methods The study population comprised icteric full term and low birth weight newborn infants. Approximately 80% of the infants were white. The full term group of infants included (1) 85 infants with no hemolytic disease