Archive for the ‘blueberry muffin baby’ Tag

Blueberry Muffin Baby: Differentials   Leave a comment

Generalised non-blanching, blue-red macules or firm dome-shaped papules on a neonate’s skin, mostly over the head, neck, trunk: a sign of extramedullary dermal haematopoiesis persisting beyond what normally occurs up to the fifth month of gestation. In the strictest sense the term describes the appearance of congenital TORCH infections; but nowadays may also refer to similar lesions in some haematologic dyscrasias and vascular malformations.

blueberry muffin baby

Link to article in the Nov 2007 issue of Archives of Paediatric and Adolescent Medicine.

Congenital Infections

  • rubella — for which this term was first coined
  • CMV (cytomegalovirus) — most common cause
  • rarely, other TORCH infections

Haemolytic diseases (Coombs positive haemolytic anaemia, unconjugated hyper-bilirubin-aemia, hydrops)

  • haemolytic disease of the newborn
  • hereditary spherocytosis


  • neuroblastoma (blanchable lesions, raccoon eyes, heterochromia irides)
  • AML (acute myeloid leukaemia) with leukaemia cutis (chloromas, pallor, lethargy, hepatosplenomegaly, fever, leukocytosis)

  • Langerhans cell histiocytosis (yellow-brown papules with central ulceration, multiple petechiae)

Vascular malformations

  • multiple haemangiomas of infancy
  • multifocal lymphangioendotheliomatosis
  • blue rubber bleb naevus syndrome
  • multiple glomangiomas


  • neonatal lupus erythematosus (occasionally)



  1. Mehta V, Balachandran C, Lonikar V. Blueberry Muffin Baby: A Pictoral Differential Diagnosis. Dermatol Online J [Internet]. 2008 [cited 3 Mar 2010];14(2). Available from:

  2. Gaffin JM, Gallagher PG. Picture of the Month & Diagnosis. Arch Pediatr Adolesc Med [Internet]. 2007 [cited 3 Mar 2010];161(11):1102-3. Available from: (Pictures)
    (Denouement and Discussion)