Transient neonatal pustular melanosis is a benign, self-limited condition of unknown etiology.  Historically, the disorder was lumped together with vesicular and bullous lesions and called pemphigus neonatorum. It was not described as a separate entity until 1976, although it may have been recognized as early as 1961 and published under the name of lentiginosis neonatorum. Note the image below.
Few reports of large numbers of screened infants are available; however, incidence has been reported to be as much as 2.2% in white infants and 4.4% in black infants.
Transient neonatal pustular melanosis is common in black infants. It can be observed in all racial groups, especially those with darker constitutive pigmentation, Latinos, South Asians, and those of Mediterranean extraction.
The eruption is almost always present at birth but the clinical appearance or stage may vary.
Neonatal pustular melanosis is a completely benign condition that is not known to cause any long-term sequelae.  The prognosis is excellent. Postinflammatory pigmented macules resolve in 2-4 months.
If pustules continue to erupt, other diagnoses should be considered.