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Transient neonatal pustular melanosis
Other Resources UpToDate PubMed

Transient neonatal pustular melanosis

Contributors: Craig N. Burkhart MD, Dean Morrell MD, Lowell A. Goldsmith MD, MPH
Other Resources UpToDate PubMed


Transient neonatal pustular melanosis (TNPM) is an idiopathic pustular disease of term newborns. Lesions begin in utero as pustules that then rupture, leaving behind collarettes of scale and hyperpigmented macules. Depending on the eruption's stage of evolution, infants are born with some combination of pustules, scale, and hyperpigmented macules. The pustules and scale resolve within 2 weeks of birth, leaving behind hyperpigmented macules that persist for several months. New lesions do not form after delivery.


P83.88 – Other specified conditions of integument specific to newborn

239092005 – Transient neonatal pustulosis

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Differential Diagnosis & Pitfalls

Transient noninfectious vesiculopustular dermatoses:
  • Miliaria crystallina and Miliaria rubra
  • Neonatal acne
  • Acropustulosis of infancy
  • Pustular eruption in Down syndrome
Persistent noninfectious vesiculopustular dermatoses:
  • Incontinentia pigmenti
  • Eosinophilic pustular folliculitis in infancy
  • Langerhans cell histiocytosis
  • Hyperimmunoglobulinemia E syndrome
  • Pustular psoriasis
If mainly consisting of scale:
  • Bullous impetigo
  • Staphylococcal scalded skin syndrome
  • Bullous congenital ichthyosiform erythroderma
  • Postmaturity desquamation
If mainly consisting of pigmented macules:
  • Multiple Lentigo simplex
  • Multiple lentigines syndrome
  • Carney complex
  • Peutz-Jeghers syndrome
  • Congenital melanocytic nevus
If there are many pustules:
  • Infectious vesiculopustular dermatoses
  • Congenital candidiasis
  • Folliculitis (superficial staphylococcal infection)
  • Neonatal listeriosis
  • Cytomegalovirus infection of newborn
  • Primary cutaneous aspergillosis of premature infants
  • Neonatal herpes simplex virus (HSV)
  • Neonatal varicella
  • Scabies
  • Invasive Haemophilus influenzae infection
  • Group A streptococcal infection
  • Pseudomonas folliculitis

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Last Updated:02/07/2022
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Transient neonatal pustular melanosis
A medical illustration showing key findings of Transient neonatal pustular melanosis : Present at birth, Hyperpigmented macules
Clinical image of Transient neonatal pustular melanosis - imageId=119239. Click to open in gallery.  caption: 'A close-up of numerous small pustules.'
A close-up of numerous small pustules.
Copyright © 2024 VisualDx®. All rights reserved.