Cook elbow macaroni in large pot of boiling salted water, until tender but firm to the bite, stirring occasionally.
Add in the poblano pepper into the boiling water and allow to blanch for four minutes, until nearly soft.
Remove pepper to cool.
Once macaroni is done, drain and set aside, adding in a tablespoon of butter and stirring.
Once poblano pepper has cooled, trim stem, seed and dice into very small pieces.
Using a medium sized, heavy duty sauce pan, warm the milk and cream together with the cayenne pepper, black pepper, and nutmeg.