DermNet NZ

Facts about the skin from DermNet New Zealand Trust. Topic index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Blueberry muffin syndrome

‘Blueberry muffin syndrome’ is the descriptive term used when an infant is born with multiple blue/purple marks or nodules in the skin. These are due to the presence of clusters of blood-producing cells in the skin (extramedullary erythropoiesis), or bleeding into the skin (purpura) or spreading cancer (metastases).

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Blueberry muffin syndrome

Causes of blueberry muffin syndrome

There are many underlying causes that need to be considered when a baby presents with blueberry muffin syndrome. These include:

Tumours such as:

Blood disorders such as:

Congenital infections such as:

The TORCH complex is a medical acronym used for these serious congenital infections: Toxoplasmosis, Other infections, Rubella, Cytomegalovirus, Herpes simplex virus. The Other infections are hepatitis B, coxsackie virus, syphilis, varicella-zoster virus and parvovirus/erythrovirus B19.

Associated symptoms and signs

Frequently there may be associated anaemia and enlargement of the liver and spleen (hepatosplenomegaly).

Infants with congenital infection may show other features such as:


The investigation and management of an infant with blueberry muffin syndrome often involves many specialists:

Investigations may include:

Treatment and prognosis

The treatment and prognosis will depend upon the underlying cause.

Related information


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Author: Dr Diana Purvis, Paediatric Dermatologist, Starship Hospital, Auckland.

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