Schachner noted that the differential diagnosis of noninfectious, usually benign neonatal vesiculopustular lesions includes acropustulosis of infancy; eosinophilic pustular folliculitis; erythema toxicum neonatorum; miliaria crystallina, rubra, or profunda; transient neonatal pustular melanosis
; and neonatal sucking blisters.
Vesiculopustular disorders of neonates are common; HSV infection, herpes zoster, congenital syphilis, neonatal acne, staphylococcal infections, bullous impetigo, epidermolysis bullosa simplex, Letterer-Siwe disease, transient pustular melanosis
, neonatal dermatitis herpetiformis, and IP all have vesiculopustular cutaneous manifestations.
Neonatal (birth-6 weeks) acne has a prevalence of 20%, though these lesions actually may represent acneiform conditions such as self-limited neonatal cephalic pustulosis or transient neonatal pustular melanosis
For example, the hyperpigmented macules or pustules that characterize transient neonatal pustular melanosis
are reported in 4.4% of African American infants and 0.2% of Caucasian infants.
The rare dermatoses, which we did not encounter in our study, include transient neonatal pustular melanosis
, subcutaneous fat necrosis of newborns, nevus sebaceous, port wine stain, supernumerary nipples and blue nevus.
Transient neonatal pustular melanosis
is more common in darker skin, compared with lighter skin; as many as 5% of African American newborns have this condition, Dr.