Blueberry muffin baby with acute myeloid leukemia and spontaneous remission

Blueberry muffin baby is a rare neonatal skin disorder. Causes for the generalized hemorrhagic purpuric eruptions include congenital infections, hemolysis, and tumors. We report a 2.5-month-old female baby with a blueberry muffin appearance, respiratory distress, and decreased activity and appetite. Skin biopsy showed diffuse infiltrates of myeloperoxidase- and lysozyrne-positive blast-like cells in dermis and superficial subcutis. Bone marrow study confirmed the diagnosis of acute monocytic leukemia with leukemia cutis. The skin nodules regressed spontaneously without chemotherapy over several days, and the peripheral blood cell counts normalized. This spontaneous remission lasted for 2 months. Spontaneous remission of infantile leukemia is rare, and its mechanism remains unknown. Although overt leukemia relapsed in some of these patients, a delay in chemotherapy spared these infants of the toxic effects of treatment. Copyright (C) 2011, Taiwanese Dermatological Association. Published by Elsevier Taiwan LLC. All rights reserved.