Neonatal Nurse Practitioner Practice Exam

What is the expected finding when aspirating pustules in a neonate suspected of having transient pustular melanosis?

1. Eosinophils

2. Neutrophils

3. Staphylococcus

4. Basophils

The correct answer is: Neutrophils

When aspirating pustules in a neonate with suspected transient pustular melanosis, the expected finding is neutrophils. This condition is characterized by the presence of superficial pustules that can resemble those seen in newborn acne or epidural pustulosis but occur without the involvement of an infectious process like staphylococcal infection. Transient pustular melanosis occurs primarily due to an inflammatory response rather than a bacterial infection. The neutrophils present in the aspirate indicate a response to the disruption of the skin barrier and tissue inflammation. Their presence suggests that the pustules contain a significant amount of white blood cells, indicating an immune reaction typically associated with dermatological processes in neonates. In contrast, the other potential findings are less indicative in the context of transient pustular melanosis. Eosinophils typically indicate allergic responses or parasitic infections, while basophils are linked to allergic reactions. Staphylococcus, being a bacterial organism, would indicate an infection rather than an inflammatory condition like transient pustular melanosis. Thus, the presence of neutrophils aligns with the expected inflammatory response rather than an infection.