Transient neonatal pustular melanosis

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Transient neonatal pustular melanosis
Other namesTransient neonatal pustulosis[1] and lentigines neonatorum[2]
Transient Neonatal Pustular Melanosis 3.jpg
Transient neonatal pustular melanosis
SpecialtyDermatology

Transient neonatal pustular melanosis (TNPM), also known as pustular melanosis, is a transient rash common in newborns. It is vesiculopustular and made up of 1-3 mm fluid-filled lesions that rupture, leaving behind a collarette of scale and a brown macule.[3] This rash occurs only in the newborn stage, usually appearing a few days after birth[2], but is sometimes already present at birth[3]. The rash usually fades over three to four weeks but may linger for up to three months after birth.[3] It can occur anywhere on the body, including the palms and soles.[1][2][3]

The cause of TNPM is unknown. No treatment is needed except for parental reassurance.

Causes[]

The cause of TNPM is unknown but it is a common rash in newborns.[3]

Histopathology[]

Gram, Wright, or Giemsa staining of the pustular contents will show polymorphic neutrophils and occasional eosinophils.[2][3] On histopathology, the pigmented macules will show basal and supra-basal increase in pigmentation without any pigmentary incontinence.[3] Bacterial culture will be negative.[4]

It has been suggested that TNPM is merely a precocious form of erythema toxicum neonatorum based on the similar histopathology.[4]

Diagnosis[]

Transient neonatal pustular melanosis is diagnosed clinically, based on appearance alone, with no need for special testing.  Proper identification is important to distinguish it from other serious, infectious neonatal diseases[3] and to help avoid unnecessary diagnostic testing and treatments.

Treatment[]

No treatment is needed except for parental reassurance. The rash spontaneously resolves, usually in three to four weeks, but may linger for up to three months after birth.[3]

Epidemiology[]

Transient neonatal pustular melanosis occurs in as much as 15% of black newborns.[3] but in less than 1% of white newborns. [2]

See also[]

  • List of cutaneous conditions

References[]

  1. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  2. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 476. ISBN 978-1-4160-2999-1.

1.    O'Connor NR, McLaughlin, MR, Ham P (2008). “Newborn Skin: Part I. Common Newborn Rashes”. American Family Physician. 77 (1): 47-52.

2.    Patrizi A, Neri I, Virid A, Gurioli C.(2016). “Frequent newborn skin diseases”. Clinical Dermatology. 4 (3-4): 82-86. doi: 10.11138/cderm/2016.4.3.082.

3.    Ghosh S. (2015). “Neonatal Pustular Dermatosis: An Overview”. Indian Journal of Dermatology. 60 (2): 211. doi: 10.4103/0019-5154.152558

4.    Ferrándiz C, Coroleu W, Ribera M, Lorenzo JC, Natal A (1992). “Sterile transient neonatal pustulosis is a precocious form of erythema toxicum neonatorum”. Dermatology. 185:18–22.

5.    Mebazaa A, Khaddar-Kort R, Cherif M, Mokni S, Haouet A, Osman B (2011). “Transient pustular eruption in neonates”. Archives de Pediatrie. 18 (3) 291-293.


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