Transient neonatal pustular melanosis (TNPM), also known as pustular melanosis, is a transient rash common in newborns. It is vesiculopustular and made up of 1–3 mm fluid-filled lesions that rupture, leaving behind a collarette of scale and a brown macule. [3] This rash occurs only in the newborn stage, usually appearing a few days after birth[2], but is sometimes already present at birth[3]. The rash usually fades over three to four weeks  but may linger for up to three months after birth. [3] It can occur anywhere on the body, including the palms and soles. [1][2][3]The cause of TNPM is unknown. No treatment is needed except for parental reassurance. Causes
The cause of TNPM is unknown but it is a common rash in newborns. [3]

Histopathology
Gram, Wright, or Giemsa staining of the pustular contents will show polymorphic neutrophils and occasional eosinophils. [2][3] On histopathology, the pigmented macules will show basal and supra-basal increase in pigmentation without any pigmentary incontinence. [3] Bacterial culture will be negative. [4]It has been suggested that TNPM is merely a precocious form of erythema toxicum neonatorum based on the similar histopathology. [4]

Diagnosis
Transient neonatal pustular melanosis is diagnosed clinically, based on appearance alone, with no need for special testing. Proper identification is important to distinguish it from other serious, infectious neonatal diseases[3] and to help avoid unnecessary diagnostic testing and treatments. Treatment
No treatment is needed except for parental reassurance. The rash spontaneously resolves, usually in three to four weeks,  but may linger for up to three months after birth.
DES was the hormonal treatment of choice for advanced breast cancer in postmenopausal women until 1977, when the FDA approved tamoxifen, a selective estrogen receptor modulator with efficacy similar to DES but fewer side effects.Several sources from medical literature in the 1970s and 1980s indicate that DES was used as a component of hormone therapy for transgender women.In 1973, in an attempt to restrict off-label use of DES as a postcoital contraceptive (which had become prevalent at many university health services following publication of an influential study in 1971 in JAMA) to emergency situations such as rape, an FDA Drug Bulletin was sent to all U.S. physicians and pharmacists that said the FDA had approved, under restricted conditions, postcoital contraceptive use of DES.In 1975, the FDA said it had not actually given (and never did give) approval to any manufacturer to market DES as a postcoital contraceptive, but would approve that indication for emergency situations such as rape or incest if a manufacturer provided patient labeling and special packaging as set out in a FDA final rule published in 1975.