European Journal of Pediatrics

, Volume 173, Issue 12, pp 1655–1658 | Cite as

An unusual case of transient neonatal pustular melanosis: a diagnostic puzzle

  • Valeria BrazzelliEmail author
  • Vincenzo Grasso
  • Giorgio Croci
  • Tiziana Figar
  • Giovanni Borroni
Case Report


A newborn's skin may exhibit a variety of changes during the first weeks of life, and rashes are extremely common in the neonatal period, representing a significant source of parental concern. In particular, a variety of skin eruptions can present as pustules. Most of them are innocuous and self-limiting, while others can be the manifestation of an infectious disease or even indicative of serious underlying disorders. Transient neonatal pustular melanosis is an uncommon vesiculopustular rash characterized by small pustules on a non-erythematous base, noted at birth or during the first day of life, without systemic symptoms. The lesions rupture spontaneously, leaving hyperpigmented macules that usually fade within few weeks. Clinical recognition of this disease can help physicians avoid unnecessary diagnostic testing and treatment for infectious etiologies because no specific therapy is recommended. The clinical aspect and time of onset are generally sufficient to make the correct diagnosis. Nevertheless, peculiar clinical presentations may require additional work-up to rule out life-threatening conditions, and dermatological consultation and histological examination are required for the final diagnosis. Conclusion: We report an exceedingly unusual presentation of transient neonatal pustular melanosis, suggesting the importance of a systematic diagnostic approach to allow a confident recognition of this benign condition.


Transient neonatal pustular melanosis Pustular rash Neonatal rash Neonatal eruption Melanosis 


Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Valeria Brazzelli
    • 1
    • 4
    Email author
  • Vincenzo Grasso
    • 1
  • Giorgio Croci
    • 2
  • Tiziana Figar
    • 3
  • Giovanni Borroni
    • 1
  1. 1.Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, Institute of Dermatology, Fondazione IRCCS Policlinico San MatteoUniversity of PaviaPaviaItaly
  2. 2.Department of Human Pathology, Fondazione IRCCS Policlinico San MatteoUniversity of PaviaPaviaItaly
  3. 3.Neonatal Intensive Care UnitFondazione IRCCS Policlinico San MatteoPaviaItaly
  4. 4.Clinica Dermatologica, Fondazione IRCCS Policlinico S. Matteo PiazzaleUniversità di PaviaPaviaItaly

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