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Transient Neonatal Pustular Melanosis
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Transient neonatal pustular melanosis (TNPM) is a harmless skin condition of newborns. The lesions of TNPM are present from birth. They begin as 2-3 mm vesiculopustules (blisters) that are not surrounded by any erythema (redness). These blisters easily rupture, leaving pigmented macules (spots) with a tell-tale collarette of scale. Blisters usually resolve within 48 hours. The remaining dark spots will gradually fade over weeks to months. Lesions may occur singly or in groups. Transient neonatal pustular melanosis may occur on any part of the newborn's body. Typical locations are the forehead, chin, behind ears, neck, and back. Palms and soles may even be affected.

No one knows the cause of transient neonatal pustular melanosis. With respect to ethnicity, TNPM occurs in approximately 5% of black infants and less than 1% of white infants. Genders are affected equally. Infants delivered at term are more likely to present with TNPM than pre-term infants.

Transient neonatal pustular melanosis is diagnosed by clinical examination. No special testing is required. However, if vesicular fluid is examined under a microscope, numerous neutrophils (a type of white blood cell) can be visualized.

Since transient neonatal pustular melanosis resolves without consequence, no treatment is necessary. New parents should be reassured that TNPM is self-limiting.


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