II. Definitions

  1. Transient Neonatal Pustular Melanosis
    1. Newborn Rash with vessicles and Pustules most common with dark complexion

III. Epidemiology: Incidence by ethnicity

  1. Black Infants: 4.4%
  2. White Infants: 0.2%

IV. Pathophysiology

  1. Benign condition
  2. Resolves spontaneously in first 3 months of life

V. Signs

  1. Size: 2 to 4 mm
  2. Initial: Milky fluid filled Pustule
  3. Later: Hyperpigmented Macule with scale (collarette appearance) after Pustule ruptures
  4. No surrounding erythema (contrast with Erythema Toxicum Neonatorum)
  5. Distribution
    1. Especially on chin, neck, trunk and buttock
    2. Can be on palms and soles

VI. Differential Diagnosis

  1. See Neonatal Pustules and Vessicles
  2. Erythema Toxicum Neonatorum variant
    1. Contrast with no surrounding erythema in Melanosis
  3. Infectious Pustules (contrast with the uniquely pigmented Macule in Melanosis)

VII. Labs

  1. Pustules contain Neutrophils on Gram Stain or wright stain
  2. Culture Negative

VIII. Management

  1. Reassurance for parents

IX. References

  1. Claudius and Behar in Herbert (2020) EM:Rap 20(8): 5-7

Images: Related links to external sites (from Bing)

Related Studies