Blueberry muffin baby
| Blueberry muffin baby | |
|---|---|
| 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 1-7 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.
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]
- ^ a b c d e f g h i j k l James, 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.
- ^ a b c d e Manning, 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.
- ^ a b c Mehta, Vandana; Balachandran, C.; Lonikar, Vrushali (28 February 2008). "Blueberry muffin baby: a pictoral [sic] differential diagnosis". Dermatology Online Journal. 14 (2): 8. doi:10.5070/D353q852nc. ISSN 1087-2108. PMID 18700111.
- ^ 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.