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Transient neonatal pustular MelanosisL81.4

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Neonatal melanosis; Transient neonatal dermatosis; Transient neonatal melanosis; Transient neonatal pustular melanosis; Transitory neonatal pustular melanosis

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HistoryThis section has been translated automatically.

Ramamurthy 1976

DefinitionThis section has been translated automatically.

Rare infant dermatosis that is already manifest at birth. The (post-inflammatory) brown spots that gave the disease its name persist for a few months, the vesicles and pustules for a few days.

Occurrence/EpidemiologyThis section has been translated automatically.

Prevalence of 4-5% in African American newborns. In Caucasian newborns the prevalence is significantly lower at 0.1-0.6% (Reginatto FP et al. 2017).

EtiopathogenesisThis section has been translated automatically.

According to current opinion, it is a variant of the erythema (toxicum) neonatorum.

ManifestationThis section has been translated automatically.

Already present at birth, increased occurrence in African-American infants.

LocalizationThis section has been translated automatically.

neck, face, trunk, palmo-plantar

Clinical featuresThis section has been translated automatically.

No general symptoms. Disseminated brown spots with non follicular vesicles and pustules scattered throughout the body. Typical infestation of Palmae and Plantae. In addition to 0.1-0.2 cm large flaccid vesicles and flaccid pustules, older lesions show brown spots with or without Collerette-like dry scaling.

In dark-skinned newborns the lesions often heal hyperpigmented. In light-skinned babies the post-inflammatory dark spotting is usually absent. The hyperpigmentations are reversible and disappear completely after 2-3 months.

HistologyThis section has been translated automatically.

Non-specific: Intra- or subcorneal aggregation of neutrophil granulocytes, occasionally eosinophils. A lympho-histiocytic inflammatory infiltrate is detectable in the corium.

DiagnosisThis section has been translated automatically.

Diagnosis based on the clinical picture. Other parameters are non-specific and not relevant for diagnosis.

Differential diagnosisThis section has been translated automatically.

Erythema (toxicum) neonatorum: Occurs only 12-48 hours after birth; lasts 3-4 days; exanthema emphasizing the extremities; no infestation of Palmae and Plantae.

Pyoderma: localized infestation; no exanthema or generalized picture; pathogen detection.

Infantscabies: not present at birth; usually localized infestation; medical history; mites.

Acropustulosis, infantile: clinically and histologically large analogies; in infantile acropustulosis the hyperpigmentations are missing.

TherapyThis section has been translated automatically.

Not required. Drying out if necessary, e.g. lotio alba.

Progression/forecastThis section has been translated automatically.

No associated systemic disease. Spontaneous healing within 3 months.

LiteratureThis section has been translated automatically.

  1. Barr RJ et al (1979) Transident neonatal pustular melanosis. Int J Dermatol 18: 636-683
  2. Ghosh S (2015) Neonatal pustular dermatosis: an overview. Indian J Dermato 60: 211
  3. Hansen LP et al (1985) Erythema toxicum neonatorum with pustulation versus transitory neonatal pustular melanosis. dermatologist 36: 475-477
  4. Mebazaa A et al (2011) Transient pustular eruption in neonates. Arch Pediatr 18: 291-293
  5. Mengesha YM et al (2002) Pustular skin disorders: diagnosis and treatment. At J Clin Dermatol 3: 389-400
  6. Ramamurthy RS, Reveri M, Esterly NB, Fretzin DF, Pildes RS (1976) Transient neonatal pustular melanosis. J Pediatr 88: 831-835

  7. Reginatto FP et al.(2017)Epidemiology and Predisposing Factors for Erythema Toxicum Neonatorum and Transient Neonatal Pustular: A Multicenter Study.Pediatric Dermatol 34:422-426.

  8. by Delft R et al.(2012) A neonate with vesicopustular rash. Ned Tijdschr Geneeskd 156:A 2816

Authors

Last updated on: 29.10.2020

Author: Prof. Dr. med. Peter Altmeyer