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Candidal infection

Neonatal candidiasis would present with beefy-red erythema and satellite pustules, often in the diaper area, unlike the inflammatory papules of neonatal acne on the face.

Hyper-IgE syndrome

While causing eczema and pustules, this is a profound immunodeficiency with other signs, not the transient papulopustular eruption of neonatal acne.

Milia

Milia are tiny, firm, white keratin cysts, not the inflammatory red papules and pustules of neonatal acne.

Miliaria rubra

This "heat rash" is caused by sweat duct obstruction and presents as tiny, pruritic red papules, not the comedonal or pustular lesions of acne.

Sebaceous hyperplasia

This presents at birth as multiple, tiny, yellowish-white papules on the nose and cheeks due to maternal androgen stimulation, and lacks the inflammatory component of neonatal acne.

Transient myeloproliferative disease

The skin lesions in this condition, associated with Down syndrome, are bluish nodules or papules representing infiltrates of blast cells.

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