Neonatal pustular melanosis is transient and benign and smears reveal predominantly neutrophils and no bacteria. Which statement best reflects this feature?

• A. It is often contagious
• B. It requires antibiotic therapy
• C. It presents with fever
• D. Smears show predominantly neutrophils and no bacteria

Answer: (D)

Neonatal pustular melanosis is a benign, self-limited pustular eruption in newborns that is sterile. The smear showing predominantly neutrophils with no bacteria indicates a noninfectious inflammatory process rather than an infection. Because there is no infectious agent, this condition is not contagious and does not require antibiotic therapy, and fever is not expected. This smear pattern—neutrophils without bacteria—best reflects its benign, noninfectious nature. If it were an infectious pustulosis, you would expect bacteria present on the smear and possible systemic signs like fever, which would change management.