Transient Neonatal Pustular Melanosis
photo by Janelle Aby, MD
All the lesions seen here are consistent with this diagnosis. The hallmark of this rash is the hyperpigmented spots that remain (seen here on the chest) after the fragile pustules (seen on the scrotum and thigh) have resolved. Because the rash starts in utero, lesions may be in any stage at birth. Despite the anxiety-provoking appearance of a newborn covered in pustules in the delivery room, no evaluation is needed when non-inflammatory pustules occur in combination with hyperpigmented macules in an otherwise well infant.
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