![]() Ī neonate with numerous discrete tiny pustules with hyperpigmented background, distributed over forehead, limbs, and trunk It has been suggested that it is merely a variant of ETN and their description has been separated for the sake of clarity. The pigmentation may persist for about 3 months but the affected neonates are otherwise entirely normal. Sometimes pigmented macules are already present at birth. Eventually the pustules rupture and form brown crust and finally a small collarette of scales. Usually distributed over chin, neck, forehead, back, and buttocks, even palms and soles may be involved. The lesions are almost invariably present at birth with 1–3 mm, flaccid, superficial, fragile pustules with no surrounding erythema. TNPM is more common in black neonates, and is probably the reason for the so-called lentigines neonatorum noted in 15% of black newborns. Transient neonatal pustular melanosis (TNPM) is an idiopathic pustular eruption that heals with brown pigmented macules. Apprehensive parents can be reassured about the benign nature of the eruption. A peripheral blood eosinophilia of up to 20% may be associated with severe cases. This review article tries to address the chronological, clinical, morphological, and histological differences among the various pustular eruptions in a newborn, in order to make it easier for a practicing dermatologist to diagnose and treat these similar looking but different entities of pustulation with a clear demarcation between the physiological benign pustular rashes and the infectious pustular lesions.Ī neonate with multiple discrete tiny pustules on erythematous base, distributed over the trunkĪ smear of the central vesicle or pustule contents reveals numerous eosinophils on Wright stain preparations. ![]() Given their ubiquitous presentation, it is sometimes difficult to differentiate among self-limiting, noninfectious, pustular dermatosis such as erythema toxicum neonatorum, transient neonatal pustular melanosis, miliaria pustulosa, etc., and potentially life threatening infections such as herpes simplex virus and varicella zoster virus infections. Its presentation is often similar with some subtle differences, which can be further established by few simple laboratory aids, to arrive at a definite diagnosis. Neonatal pustular eruption is a group of disorders characterized by various forms of pustulosis seen in first 4 weeks of life. ![]()
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