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Author: Dr Diana Norris, Dermatology Registrar, Skin and Cancer Foundation Victoria, Carlton, VIC, Australia. DermNet New Zealand Editor in Chief: Adjunct A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Copy edited by Gus Mitchell/Maria McGivern. February 2018.
Transient neonatal pustular melanosis is an uncommon benign pustular condition presenting in newborn infants . It is also known as transient neonatal pustular dermatosis and transient neonatal pustulosis.
Transient neonatal pustular melanosis affects 0.2–4% of newborn infants in the first few days of life . It is more common in African-American babies, affecting 4.4% of African-American than in Caucasians .
The cause of transient neonatal pustular melanosis is unknown. Some authors have suggested it may be a variant of toxic erythema of the newborn .
The key clinical feature of transient neonatal pustular melanosis is the presence of pustules. These occur on an unaffected, non-erythematous base .
The diagnosis of transient neonatal pustular melanosis is clinical. No investigations are required.
A skin biopsy shows a neutrophilic infiltrate in the epidermis or dermis, commonly with subcorneal pustules, and occasional eosinophils [2,5]. Pustules contain neutrophils with no organisms .
The differential diagnosis for transient neonatal pustular melanosis includes:
No treatment is necessary for transient neonatal pustular melanosis, as it is self-resolving and has no long-term complications [5,6].
FerrándizC, Coroleu LW, Ribera M, Lorenzo JC, Natal A. Sterile transient neonatal pustulosis is a precocious form of erythema toxicum neonatorum. Dermatology 1992; 185: 18–22. DOI: 10.1159/000247396. PubMed.
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