Blueberry muffin babyP61.8

The term "blueberry muffin" refers to skin changes that are often characterized by blueberry-like efflorescences shimmering through the skin. It is a transient cutaneous extramedullary haematopoiesis occurring exclusively in the neonatal period as a result of a serious underlying disease which leads to the temporary reactivation of embryonic or fetal haematopoietic mechanisms after birth.

Fetal infectious diseases or diseases of the mother during pregnancy ( toxoplasmosis, rubella, herpes, zoster, cytomegaly), haematolytic diseases of the fetus and resulting anaemia and neoplasia are described.

Postnatal or in the neonatal period.

Trunk, face, extremities, palmae, plantae.

During birth or shortly after birth (especially 24-48 hours post partum) suddenly petechiae, disseminated or densely standing red to reddish-brown spots, papules and plaques; blueberry-coloured or reddish ecchymoses develop. Often acrocyanosis.

Left shift in the differential blood count.

Edematous loosening of the perivascular and periadnexial spaces of the middle or deep dermis. Often infiltrates of different neoplastic proliferations or immature cells of erythropoiesis, granulopoiesis or thrombocytopoiesis.

Clinic, histology, differential blood count, pathogen detection if necessary.

Treatment of the underlying disease. Spontaneous regression of the efflorescences.

Red cell concentrates if necessary.

The complex clinical picture is called TORCH syndrome. TORCH is an acronym for the pathogens: Toxoplasma gondii, Other (Treponema pallidum, Hepatitis B, Zoster), Rubella virus, Z(C)ytomegalovirus, Herpes simplex virus.