Transient neonatal pustular melanosis

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Transient neonatal pustular melanosis
Other names: Transient neonatal pustulosis,[1] lentigines neonatorum[2]
Transient Neonatal Pustular Melanosis 3.jpg
Transient neonatal pustular melanosis
SpecialtyDermatology
SymptomsMultiple small dark, fluid-filled bumps in the skin of a newborn[1]
Usual onsetBirth[3]
CausesNot clear[4]
Diagnostic methodBy appearance[4]
Differential diagnosisErythema toxicum neonatorum[3]
TreatmentNot required[3]
PrognosisGood[3]
FrequencyCommon, 5% of black African-American newborns, males=females[3]

Transient neonatal pustular melanosis (TNPM), also known as pustular melanosis, presents with multiple small dark, fluid-filled bumps in the skin of a newborn.[1] They are usually 1mm to 3mm in size, but can be up to 1cm.[1] Some may have resolved before being born, leaving brownish spots.[3] The appearance of news bumps may indicate an alternative diagnosis.[1]

The cause of TNPM is not clear.[4] The condition gets better without treatment.[3]

TNPM is common, has been reported in 5% of black African-American newborns and 0.2% of white American newborns.[3] Males and females are affected equally.[3]

Symptoms and signs

Transient neonatal pustular melanosis

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.[1] This rash occurs only in the newborn stage, usually appearing a few days after birth but is sometimes already present at birth.[1]

The rash usually fades within a week.[4] It can occur anywhere on the body, including the palms and soles.[3]

Causes

The cause of TNPM is not clear.[4]

Histopathology

Gram, Wright, or Giemsa staining of the pustular contents will shows a mixture of mostly neutrophils and some eosinophils.[1] On histopathology, the pigmented macules will show basal and supra-basal increase in pigmentation without any pigmentary incontinence.[5] Bacterial culture will be negative.[6]

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 by its appearance alone.[4]

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.[5]

Epidemiology

TNPM is common, has been reported in 5% of black African-American newborns and 0.2% of white American newborns.[3] Males and females are affected equally.[3]

See also

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "36. Disturbances of pigmentation: Transient neonatal pustular melanosis". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. pp. 867–868. ISBN 978-0-323-54753-6. Archived from the original on 2022-08-15. Retrieved 2022-08-12.
  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.
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 Reginatto, FP; Villa, DD; Cestari, TF (April 2016). "Benign skin disease with pustules in the newborn". Anais brasileiros de dermatologia. 91 (2): 124–34. doi:10.1590/abd1806-4841.20164285. PMID 27192509. Archived from the original on 2021-08-29. Retrieved 2022-08-12.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 4.6 Norris, Diana (2018). "Transient neonatal pustular melanosis | DermNet NZ". dermnetnz.org. Archived from the original on 14 August 2021. Retrieved 12 August 2022.
  5. 5.0 5.1 “Neonatal Pustular Dermatosis: An Overview”. Indian Journal of Dermatology. 60 (2): 211. doi: 10.4103/0019-5154.152558
  6. 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.