Transient Blueberry Muffin Appearance of a Newborn with Congenital Monoblastic Leukemia

Case Details

Personal Characteristics

A full-term male infant, born on january 1, 1986, to a 22- year-old woman WHO was blood type a, rh positive, free of venereal disease, and immune to rubella after a normal gestation, labor and delivery. The infant was blood type b, rh positive

Clinical Characteristics

Skin findings suggesting a blueberry muffin appearance, tachypneic, scattered randomly over the trunk, scalp, and extremities were dusky red to purple macules, papules, and nodules measuring 3 to 15 millimeters in diameter. The nodules did not blanch with vigorous rubbing. Petechiae, adenopathy, and hepatosplenomegaly were absent. The remainder of the physical examination were normal. No features of down syndrome were observed

Remission Characteristics

The infant has remained well 2 years after spontaneous resolution of the cutaneous eruption. The skin lesions began to fade spontaneously within 1 week and were absent after 4 weeks. New lesions have not occurred. Hematologic parameters have been monitored routinely for 2 years and have remained consistently normal

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

The infant was treated for possible sepsis and pneumonia

Additional Notes

Infiltrative neoplasms should be considered along with congenital infections and hematologic disorders in the differential diagnosis of a newborn with a blueberry muffin appearance. Spontaneous remissions can occur in many cases of congenital leukemia, especially in those infants with Down syndrome. These remissions, however, are often temporary, with recurrences up to 2 years after birth. Our patient has remained in remission for 26 months