White or yellow papules on a red macular base that can be found on the face, trunk or proximal extremities is most consistent with:

• A. Miliaria crystalline
• B. Milia
• C. Pustular melanosis
• D. Erythema toxicum

Answer: (D)

Recognize this as erythema toxicum neonatorum, a common benign newborn eruption. It presents as white or yellow papules or vesicles on an erythematous base and can appear on the face, trunk, and proximal extremities. It typically shows up in the first day or two of life and resolves on its own within 1–2 weeks without treatment. The combination of white or yellow papules atop a red macular base is classic for ET. Milia are white keratin-filled cysts on the face without an associated red base; miliaria involves vesicles from sweat duct blockage and often has a different vesicular pattern; pustular melanosis appears at birth with pustules that leave hyperpigmented macules. This description most closely matches erythema toxicum neonatorum.