TRANSIENT NEONATAL PUSTULOSIS
By Gary M. White, MD
Also known as transient neonatal pustular melanosis, transient neonatal pustulosis (TNP) is characterized by pustules present at birth. It is most common in black infants with an incidence of about 2-5%, but may occur less frequently in white infants as well. The addition of the term melanosis is not preferred as white infants do not develop the pigmentary changes.
- Transient neonatal pustulosis is a benign, self-limiting, noninfectious, pustular dermatosis of infants.
- It must be distinguished from other benign conditions, including erythema toxicum neonatorum, impetigo, miliaria pustulosa, etc., and potentially life threatening infections such as herpes simplex virus and varicella zoster virus infections.
At birth, multiple, small, fragile pustules are present. The chin, neck, back and buttocks are favorite sites. After rupture, a collarette of scale may be present, followed by a dark macule in black infants. These pigmented macules may be present at birth, implying the potential development of TNP in utero.
For a nice review of neonatal pustular eruptions, see Neonatal pustular dermatosis: An overview. Indian J Dermatol 2015;60:211.
If there is any question about the diagnosis, infection with bacterial, herpes or fungus should be excluded.
No treatment is needed. The condition is transient. Any dark macules will fade over several months.
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