A newborn baby with typical lesions of a blueberry muffin baby.
Specialty
Pediatrics, dermatology
Symptoms
Reddish-blue purpura localized mainly to the face, neck, and trunk[1]
Causes
Congenital rubella, congenital CMV, other TORCH infections, blood disorders, and malignancies[1]
Diagnostic method
Blood tests for complete blood count, TORCH infections, haemoglobin, viral cultures and Coombs test, skin biopsy[1]
Differential diagnosis
Hemangiopericytoma, blue rubber bleb nevus, hemangioma, glomangioma[1]
Prevention
MMR vaccine covers for congenital rubella
Frequency
Uncommon[2]
Blueberry muffin baby, also known as extramedullary hematopoiesis, describes a newborn baby with multiple purpura, associated with several non-cancerous and cancerous conditions in which extra blood is produced in the skin.[1] The bumps range from one to seven mm, do not blanch and have a tendency to occur on the head, neck and trunk.[1] They often fade by three to six weeks after birth, leaving brownish marks.[3] When due to a cancer, the bumps tend to be fewer, firmer and larger.[2]
The condition can occur following infection of an unborn baby with rubella, cytomegalovirus, toxoplasmosis, or coxsackie virus.[4] Other viral causes include parvovirus B19 and herpes simplex.[1] Non-infectious causes include haemolytic disease of the newborn, hereditary spherocytosis, twin-to-twin transfusion syndrome and recombinant erythropoietin administration.[1] Some types of cancers can cause it such as rhabdomyosarcoma, extrosseal Ewing sarcoma, Langerhans cell histiocytosis, congenital leukaemia and neuroblastoma.[1] During normal development of an unborn baby, blood production can occur in the skin until the fifth month of pregnancy.[3] Blueberry muffin lesions in the newborn indicate the prolongation of skin blood production after birth.[3]
Diagnosis involves a combination of appearance and laboratory studies, including blood tests for complete blood count, TORCH infections, haemoglobin, viral cultures and Coombs test.[1] A skin biopsy may be useful.[1] Conditions that may appear similar include hemangiopericytoma, blue rubber bleb nevus, hemangioma and glomangioma.[1]
Prognosis is variable based upon the cause of the characteristic rash. Treatment may include supportive care, anti-viral medication, transfusion, or chemotherapy depending on the underlying cause.[citation needed]
It is not common.[2] The term was coined in the 1960s to describe the skin changes in babies with congenital rubella.[2] Since then, it has been realised that blueberry muffin marks occur in several conditions.[2]
^ abcdefghijklJames, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "35. Cutaneous vascular diseases". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. p. 831. ISBN 978-0-323-54753-6. Archived from the original on 2022-03-26. Retrieved 2022-03-26.
^ abcdeManning, Jamie Rosen; Lee, Diana H. (1 January 2019). "Uncommon Neonatal Skin Lesions". Pediatric Annals. 48 (1): e30–e35. doi:10.3928/19382359-20181212-02. ISSN 1938-2359. PMID 30653640. S2CID 58611792. Archived from the original on 30 March 2022. Retrieved 30 March 2022.
^Johnstone, Ronald B. (2017). "12. Disorders of elastic tissue". Weedon's Skin Pathology Essentials (2nd ed.). Elsevier. p. 763. ISBN 978-0-7020-6830-0. Archived from the original on 2021-05-25. Retrieved 2022-03-26.
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