Appearance of Epstein pearls in the mouth of newborn infants

Epstein's pearls are very common and benign small white or yellow cystic vesicles (1 to 3 mm in size) often seen in the median palatal raphe of the mouth of newborn infants (occur in 65-85% of newborns).

It represents epithelial tissue that becomes trapped during the palatal fusion. On palpation, these are firm papules that can be appreciated when the infant is sucking on the examiner's finger. They do not require treatment as they resolve spontaneously over the first few weeks of life.

Epstein Pearl in 5 week old infant