Neonatal leukaemia cutis

Abstract

Neonatal leukaemia cutis is a significant neoplasm that may represent a cutaneous manifestation of systemic leukaemia, usually of myeloblastic type. Rarely, it may be or appear to be limited to skin, in which case it is called neonatal aleukaemic leukaemia cutis. By definition, it presents within the first 4 weeks of life and often has a 'blueberry muffin baby' appearance of magenta coloured nodules affecting almost any area of the skin, usually sparing mucous membranes, palms and soles. This clinical pattern is more commonly associated with neonatal infections such rubella and toxoplasmosis, and may be evident with other neonatal neoplasms such as neuroblastoma. Due to the morbidity associated with chemotherapy and reported cases of spontaneous remission without systemic progression in those with neonatal aleukaemic leukaemia cutis without 11q23 translocation, the authors not treating the child with chemotherapy, but to simply monitor for fading of the violaceous nodules, and watch for possible signs of systemic leukaemia.

Leukemia Cutis in Childhood Acute Myeloid Leukemia: Epidemiological, Clinical, Biological, and Prognostic Characteristics of Patients Included in the ELAM02 Study

“…A likely role of MLL -rearrangement could explain such results since MLL -rearranged AML is known to be more aggressive particularly in cases of neonatal LC with 11q23 rearrangement. 1 However, we found no difference in OS for patients in LC+ group depending on presence or absence of MLL -rearrangement. Another study concluded prognosis, particularly EFS differs depending on translocation partner for MLL gene.…”

“…Several cases have been reported in newborns and infants suggesting that skin lesions are common in neonatal leukemia but there is no study on a larger scale in pediatric patients. 1,2…”

“…3,5,6 Age could be a confounding factor since FAB type M5 is more common in very young children. 1,7…”

Dermoscopic findings in neonatal leukemia cutis

“…Blueberry muffin baby is a descriptive umbrella term for purpuric lesions in association with a variety of intrauterine congenital infections, hematologic disorders, autoimmune conditions, proliferative states, and vascular anomalies . Therefore, a wide range of etiologies must be excluded.…”

“…Neonatal leukemia cutis is an important disorder that may present as a blueberry muffin baby and may represent the cutaneous manifestation of systemic leukemia . As such, it must be distinguished from a variety of infectious, vascular, and neoplastic etiologies.…”