Transient Neonatal Pustular Melanosis
Larissa V. Furtado, MD
Key Facts
Clinical Issues
Benign, self-limited dermatosis
Most commonly occur in African-American infants (˜ 4-5%)
No gender predilection
Lesions are apparent at birth or develop over 1st 24 hours of life
Small vesicopustules with a nonerythematous base
Treatment is often unnecessary
Microscopic Pathology
Subcorneal pustules containing neutrophils and occasional eosinophils
Intracorneal neutrophilic infiltrate
Dermis is usually uninvolved
Tzanck smear may show neutrophils ± eosinophils
Ancillary Tests
Direct and indirect immunofluorescence is negative for deposits of antibody and complement
 Biopsy of transient neonatal pustular melanosis (TNPM) shows a subcorneal pustule  containing predominantly neutrophils and a few eosinophils  . |
 In acropustulosis of infancy, the subcorneal pustule  contains numerous eosinophils  , which may be admixed with a variable amount of neutrophils. (Courtesy M. Chaffins, MD.) |
TERMINOLOGY
Abbreviations
Transient neonatal pustular melanosis (TNPM)
