II. Definitions
- Transient Neonatal Pustular Melanosis
- Newborn Rash with vessicles and Pustules most common with dark complexion
III. Epidemiology: Incidence by ethnicity
- Black Infants: 4.4%
- White Infants: 0.2%
IV. Pathophysiology
- Benign condition affecting skin containing higher levels of Melanin
- Resolves spontaneously in first 3 months of life
V. Signs
- Size: 2 to 4 mm
- Pustular rash present at birth
- Initial: Milky fluid filled Pustule
- Next: Pustule ruptures
- Leaves a hyperpigmented Macule with scale (collarette appearance)
- Hyperpigmentation may persist for weeks to months before fading
- No surrounding erythema (contrast with Erythema Toxicum Neonatorum)
- Distribution
- Most common on the chin and neck, but also present on the forehead and behind the ears
- Also involves the trunk and buttocks
- Can be on palms and soles
VI. Differential Diagnosis
- See Neonatal Pustules and Vessicles
-
Erythema Toxicum Neonatorum variant
- Contrast with no surrounding erythema in Melanosis
- Infectious Pustules (contrast with the uniquely pigmented Macule in Melanosis)
VII. Labs
- Pustules contain Neutrophils on Gram Stain or wright stain
- Culture Negative
VIII. Management
- Reassurance for parents
IX. References
- Claudius and Behar in Herbert (2020) EM:Rap 20(8): 5-7
- Snyder (2024) Am Fam Physician 109(3): 212-6 [PubMed]
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Related Studies
| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 239092005 |
| English | Trans neonat pustular melanos, Transient neonatal pustular melanosis, Transient neonatal pustulosis, Transient neonatal pustulosis (disorder) |
| Czech | Tranzientní neonatální pustulózní melanóza |
| Dutch | voorbijgaande neonatale pustuleuze melanose |
| French | Mélanose pustulaire néonatale transitoire |
| German | Transiente neonatale pustuloese Melanose |
| Hungarian | Átmeneti neonatalis pustulosus melanosis |
| Italian | Melanosi pustulosa transitoria del neonato |
| Japanese | ｲｯｶｾｲｼﾝｾｲｼﾞﾉｳﾎｳｾｲﾒﾗﾉｰｼｽ, 一過性新生児膿疱性メラノーシス |
| Portuguese | Melanose pustulosa neonatal transitória |
| Spanish | Melanosis pustulosa neonatal transitoria, melanosis pustulosa neonatal transitoria, pustulosis neonatal transitoria (trastorno), pustulosis neonatal transitoria |
Ontology: neonatal pustular melanosis (C2230948)
| Concepts | Disease or Syndrome (T047) |
| English | neonatal pustular melanosis, neonatal pustular melanosis (diagnosis) |
