Annular Migratory Rash In a Newborn Related to Prostaglandin E1 Infusion: A Case Report

Prostaglandin E1 (PGE1, alprostadil) is essential in managing ductus-dependent congenital heart defects (CHD) in neonates. Although its common adverse effects are well documented, dermatologic manifestations remain rare and underrecognized. We report a term male neonate with a prenatal diagnosis of complex critical CHD who required PGE1 infusion and subsequently developed an annular migratory rash on the third postnatal day. The rash resolved within minutes of PGE1 dose reduction but recurred upon dose escalation, strongly suggesting a causal link. Following surgical palliation and discontinuation of PGE1, the skin findings resolved completely and did not recur. This case underscores a rare but distinctive cutaneous reaction to PGE1 therapy and highlights the importance of early recognition to avoid unnecessary diagnostic testing and interruption of life-saving treatment.