Neonatal Pustular Melanosis

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Transient neonatal pustular melanosis is a benign, self-limited condition of unknown etiology. [1] Historically, the disorder was lumped together with vesicular and bullous lesions and called pemphigus neonatorum. It was not described as a separate entity until 1976, although it may have been recognized as early as 1961 and published under the name of lentiginosis neonatorum. Note the image below.

Few reports of large numbers of screened infants are available; however, incidence has been reported to be as much as 2.2% in white infants and 4.4% in black infants.

Transient neonatal pustular melanosis is common in black infants. It can be observed in all racial groups, especially those with darker constitutive pigmentation, Latinos, South Asians, and those of Mediterranean extraction.

The eruption is almost always present at birth but the clinical appearance or stage may vary.

Neonatal pustular melanosis is a completely benign condition that is not known to cause any long-term sequelae. [2] The prognosis is excellent. Postinflammatory pigmented macules resolve in 2-4 months.

If pustules continue to erupt, other diagnoses should be considered.

Eichenfield LF, Frieden IJ, Esterly NB, eds. Neonatal Dermatology. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008. 142.

O’Connor NR, McLaughlin MR, Ham P. Newborn skin: Part I. Common rashes. Am Fam Physician. 2008 Jan 1. 77(1):47-52. [Medline].

Chia PS, Leung C, Hsu YL, Lo CY. An infant with transient neonatal pustular melanosis presenting as pustules. Pediatr Neonatol. 2010 Dec. 51(6):356-8. [Medline].

Goyal T, Varshney A, Bakshi SK. Incidence of Vesicobullous and Erosive Disorders of Neonates: Where and How Much to Worry?. Indian J Pediatr. 2011 Oct 25. [Medline].

Morgan AJ, Steen CJ, Schwartz RA, Janniger CK. Erythema toxicum neonatorum revisited. Cutis. 2009 Jan. 83(1):13-6. [Medline].

Ghosh S. Neonatal pustular dermatosis: an overview. Indian J Dermatol. 2015 Mar-Apr. 60 (2):211. [Medline].

Robert A Silverman, MD Clinical Associate Professor, Department of Pediatrics, Georgetown University Medical Center

Robert A Silverman, MD is a member of the following medical societies: American Academy of Dermatology, Society for Pediatric Dermatology

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Kevin P Connelly, DO Clinical Assistant Professor, Department of Pediatrics, Division of General Pediatrics and Emergency Care, Virginia Commonwealth University School of Medicine; Medical Director, Paws for Health Pet Visitation Program of the Richmond SPCA; Pediatric Emergency Physician, Emergency Consultants Inc, Chippenham Medical Center

Kevin P Connelly, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Osteopathic Pediatricians, American Osteopathic Association

Disclosure: Nothing to disclose.

The authors and editors at Medscape Reference gratefully acknowledge the contributions of previous author Elaine B St John, MD, to the original writing and development of this article.

Neonatal Pustular Melanosis

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