FETOMATERNAL HEMORRHAGE AND PRENATAL INTRACRANIAL BLEEDING - 2 MORE CAUSES OF BLUEBERRY MUFFIN BABY

Blueberry muffin lesions are associated with prenatal infections, seve re and chronic anemia and neoplastic infiltrative diseases. In the fir st two instances they represent postnatal re-expression of cutaneous h aematopoiesis, in the latter they are cutaneous localizations of a neo plastic disease. Chronic prenatal anaemia leading to blueberry muffin lesions in the neonate has been reported in association with severe ha emolytic anaemia such as congenital spherocytosis, Rhesus haemolytic d isease and ABO incompatibility, or in anaemia caused by twin-to-twin t ransfusion. We present two more causes of prenatal anaemia leading to blueberry muffin lesions: chronic fetomaternal haemorrhage and severe intracranial bleeding. Conclusion In any blueberry muffin baby with pr ofound anaemia, chronic fetomaternal haemorrhage and severe internal b leeding should be included in the differential diagnosis. Skin biopsy must be performed to rule out neoplastic infiltrative diseases.