Acute Myelomonocytic Leukemia with Skin Localizations

Abstract

We present a case of acute myelomonocytic leukemia with skin localizations in which complete remission was obtained with aggressive chemotherapy. The importance of leukemia cutis in the differential diagnosis of the ‘blueberry muffin baby’ is discussed.

Fetomaternal haemorrhage and prenatal intracranial bleeding: two more causes of blueberry muffin baby

“…Dierential diagnosis of blueberry mun lesions includes neoplastic in®ltrative disease such as metastasis of neuroblastoma (stage IV-S) or congenital alveolar rhabdomyosarcoma, congenital leukaemia and congenital histiocytosis (Letterer-Siwe disease, self-healing reticulohistiocytosis) [5,7,9,10,11,13]. These diseases typically present with more nodular and in®ltrated lesions [3].…”

“…These diseases typically present with more nodular and in®ltrated lesions [3]. Lesions that progressively expand after birth instead of disappearing are more suggestive of a neoplastic disorder [10]. Histopathological data, electron microscopy, immunohistochemistry and bone marrow aspirate will help to de®ne the type of lesion [5,10].…”

“…Lesions that progressively expand after birth instead of disappearing are more suggestive of a neoplastic disorder [10]. Histopathological data, electron microscopy, immunohistochemistry and bone marrow aspirate will help to de®ne the type of lesion [5,10]. In cases of congenital leukaemia with cutaneous nodules, trisomy 21 should be ruled out, including mosaicism in bone marrow, blood cells and skin ®broblasts, because spontaneous remission is more likely in these patients, avoiding the need for chemotherapy, which may cause signi®cant morbidity and mortality in the neonatal age group [7,10].…”

Congenital rubella syndrome presenting at birth with blueberry muffin rash and communicating hydrocephalus

“…Intrauterine infections associated with blueberry muffin rash are rubella, toxoplasmosis, varicella, cytomegalovirus, herpes simplex, coxsackievirus B-2, human parvovirus B19, and HIV [3]. They are also found in various hematological disorders such as twin-to-twin transfusion, Rh hemolytic disease of the newborn, diffuse neonatal hemangiomatosis, congenital leukemias, neuroblastoma, histiocytosis, rhabdomyosarcoma and rarely with genetic polymalformative syndrome [7][8][9]. Blueberry muffin rash is never idiopathic.…”