Presentation
The lesions often present as, or evolve into, a pigmented macule and persist from three weeks to three months. [uthscsa.influuent.utsystem.edu]
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. [ncbi.nlm.nih.gov]
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. [unboundmedicine.com]
Transient Neonatal Pustular Melanosis TNPM is a condition marked by pustules and vesicles that are present at birth, and which heal with a collarette of scale and, eventually, a hyperpigmented macule. [dermchallenge.blogspot.com]
Skin
- Ulcer
Primary lesions (vesicles, bullae, or pustules) often are hidden in a sea of secondary changes (erosions, ulcerations, or crusting). [pedsinreview.aappublications.org]
In some cases, the hemangioma ulcerates due to its rapid growth and the consequent thinning of the epidermis. [ijdvl.com]
[…] eyebrows, twist 2 gene, AR Cutis Marmorata Telangiectatica Congenita - onset at birth, improves w/age - blanching reticulated vascular pattern on trunk/ext w/segmental distribution - a/w anomalies in 1/2 pts (varicosities, nevus flammeus, macrocephaly, ulceration [studyblue.com]
Blisters and ulcers of recessive dystrophic epidermolysis bullosa Ecchymoses and crusts Similar infective, traumatic and genetic causes should be considered in neonates presenting with ecchymoses and crusts. [racgp.org.au]
Introduction A large number of conditions can cause vesicles (small blisters), pustules (yellow blisters), bullae (big blisters), erosions (sores) and ulcerations during the newborn period. [dermnetnz.org]
- Cafe-Au-Lait Spots
[…] is another example of cafe au lait spot. [med.stanford.edu]
Other birthmarks include cafe-au-lait spots, or spots that look like coffee with cream. [babygaga.com]
- Hypertrichosis
Nevi vary in size from small to large, and often have associated hypertrichosis. [plasticsurgerykey.com]
Smooth muscle hamartoma A smooth muscle hamartoma is composed of arrector pili muscles. [10] Clinically, the lesion exhibits hyperpigmentation and hypertrichosis overlying a firm, nodular base. On occasion, a lesion may "ripple" when it is stroked. [ijdvl.com]
Neurologic
- Seizure
[…] birth Lesions do not enlarge but remain flat and persist When port wine stain involves ophthalmic branch of the fifth cranial (trigeminal) nerve, it can be associated be a constellation termed Sturge-Weber syndrome Sturge-Weber syndrome involves seizures [dontforgetthebubbles.com]
• CNS disease presents with fever, lethargy, and focal seizures. 7. [slideshare.net]
Glaucoma is one of the classic features of the Sturge-Weber triad (i.e., nevus flammeus, seizures and glaucoma). When a nevus flammeus is located around the eye, glaucoma can occur with or without a diagnosis of Sturge-Weber syndrome. [ijdvl.com]
- Convulsions
[…] specified conditions of integument specific to newborn P83.81 Umbilical granuloma P83.88 Other specified conditions of integument specific to newborn P83.9 Condition of the integument specific to newborn, unspecified P84 Other problems with newborn P90 Convulsions [icd10data.com]
Workup
Microbiology
- Malassezia Furfur
Neonatal Malassezia furfur pustulosis. Arch Dermatol. 1996;132:190-3. [ Links ] 33. Yañes-Díaz S, Martínez-Herrera B, González-López MA. Pustulosis cefálica neonatal por «Malassezia». Acta Pediatr Esp. 2008;66:299-301. [ Links ] 34. [scielo.org.mx]
Malassezia furfur in infantile seborrheic dermatitis. Pediatr Dermatol. 1997;14(6):423–425. 16. Mimouni K, Mukamel M, Zeharia A, Mimouni M. Prognosis of infantile seborrheic dermatitis. J Pediatr. 1995;127(5):744–746. 17. [aafp.org]
Probably hormonal fluctuations and the colonization by Malassezia furfur may explain the distribution of the lesions, playing a role in the pathogenesis of this disease ( 4 ). [clinicaldermatology.eu]
Treatment
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Make informed clinical choices for each patient, from diagnosis and treatment selection through post-treatment strategies and management of complications, with new evidence-based criteria throughout. [books.google.com]
No treatment is needed. http://www.skinsight.com/infant/erythemaToxicumNeonatorum.htm http://www.webmd.com/skin-problems-and-treatments/picture-of-erythema-to... [pedclerk.bsd.uchicago.edu]
Treatment includes topical anti-yeast agents such as nystatin, clotrimazole, and econazole. [hawaii.edu]
Clinical recognition of this disease can help physicians avoid unnecessary diagnostic testing and treatment for infectious etiologies because no specific therapy is recommended. [ncbi.nlm.nih.gov]
Prognosis
Prognosis Neonatal pustular melanosis is a completely benign condition that is not known to cause any long-term sequelae. [2] The prognosis is excellent. Postinflammatory pigmented macules resolve in 2-4 months. [emedicine.medscape.com]
Part I of this article reviews the presentation, prognosis, and treatment of the most common rashes that present during the first four weeks of life. [aafp.org]
Keywords: neonatal, transient, skin disease Introduction The majority of the dermatologic findings in neonates are physiological and transient so no treatment is required; parents can therefore be reassured about the good prognosis. [clinicaldermatology.eu]
Etiology
It is a benign and self-limited disease, and the etiology is still unknown. We present a full-term female neonate with multiple vesiculopustular and pigmented macular lesions found immediately after her birth. [ncbi.nlm.nih.gov]
Clinical recognition of this disease can help physicians avoid unnecessary diagnostic testing and treatment for infectious etiologies because no specific therapy is recommended. [unboundmedicine.com]
College of Medicine, Korea University, Seoul, Korea Corresponding Author: Baik Lin Eun ,Email: 1 Copyright © 1999 by The Korean Pediatric Society ABSTRACT Transient neonatal pustular melanosis(TNPM) is a benign, self-limited, cutaneous disorder of unknown etiology [kjp.or.kr]
Epidemiology
The brown macules may persist for several months. [3, 5] Epidemiology Frequency United StatesPreviously published incidence rates for transient neonatal pustular melanosis are 0.6% in white infants and 4.4% in African American infants. [thehealthscience.com]
Epidemiology US frequency 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. [emedicine.medscape.com]
Prospective study of erythema toxicum neonatorum: epidemiology and predisposing factors. Pediatr Dermatol. 2012 Mar-Apr;29(2):166-8 4. Rudnick CM, Hoekzema GS. Neonatal herpes simplex virus infections. Am Fam Physician. 2002 Mar 15;65(6):1138-42. [mdmag.com]
Epidemiologic study of the predisposing factors in erythema toxicum neonatorum. Dermatology. 2005;210(4):269–272. 5. Carr JA, Hodgman JE, Freedman RI, Levan NE. Relationship between toxic erythema and infant maturity. [aafp.org]
Prevention
Although it is rare in Taiwan and Asian countries, transient neonatal pustular melanosis should always be considered when pustulosis is found in the neonatal period to prevent the use of unnecessary antibiotics. [ncbi.nlm.nih.gov]
Dentistry Periodontics Preventive Community Dentistry Prosthodontics Prosthodontics and Crown and Bridge Public Health Dentistry Emergency Medicine Emergency Medicine Endocrinology Endocrinology Diabetology ENT Ear Nose and Throat Speech Therapy Forensic [medyhealth.com]
The information presented here is not intended to diagnose, treat, cure or prevent any disease. Read disclaimer. [gulfdoctor.net]
Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs [emedicine.medscape.com]