Transient Neonatal Pustular Melanosis Differential Diagnoses

Updated: Jan 25, 2019
  • Author: Jennifer Sorrell, MD; Chief Editor: William D James, MD  more...
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Diagnostic Considerations

Also consider the following:

  • Acne neonatorum
  • Congenital candidiasis
  • Impetigo neonatorum
  • Erythema toxicum
  • Staphylococcal infection
  • Ofuji syndrome
  • Neonatal varicella
  • Congenital dermal melanocytosis or Mongolian spots: These are bluish-black macular patches on the back and lumbosacral area; they are more common in dark-skinned babies than in light-skinned babies.

Failure to recognize and distinguish this condition from other neonatal pustular and vesicular dermatoses with more serious systemic implications can be problematic. Infectious causes of vesicles or pustules in the newborn can be bacterial (including spirochetal), fungal, or viral. Congenital herpes simplex infection is an important differential, although in this condition the vesicles and pustules occur in "crops" on erythematous bases. [12] Because pustules can be a manifestation of sepsis, it is important to consider all infectious etiologies.

Differential Diagnoses