Neonatal eosinophilic pustulosis in a 2-month old

We describe a 2-month-old preterm neonate presenting with neonatal eosinophilic pustulosis, manifesting as grouped pustules on the cheeks, leukocytosis and marked blood eosinophilia, and histology demonstrating abundant eosinophils without follicular involvement. Complete resolution of his skin lesions occurred spontaneously by 4 months of age, paralleling a decline in his eosinophil count. We discuss the relationship of this eruption to other pustular disorders of infancy and hypothesize a mechanism that may initiate the eruption.