Vesiculopustular eruptions in Down syndrome neonates with myeloproliferative disorders

A Nijhawan1, E Baselga, M A Gonzalez-Ensenat

  • 1Department of Dermatology, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226, USA.

Insights

Infants with Down syndrome experiencing myeloproliferative disorders may develop a unique skin rash. This self-resolving eruption presents distinct clinical and histopathologic features, potentially aiding diagnosis.

Area of Science:

  • Neonatal Dermatology
  • Pediatric Hematology
  • Clinical Genetics

Background:

  • Infants with Down syndrome (DS) have a higher incidence of hematologic abnormalities, including transient myeloproliferative disorder (TMD) and congenital leukemia.
  • The differential diagnosis for vesiculopustular eruptions in newborns with DS and hematologic issues is extensive, encompassing both benign and severe conditions.

Observation:

  • This study details 3 newborns with DS presenting with vesiculopustular eruptions linked to neonatal myeloproliferative disorders.
  • These skin lesions exhibit a distinct distribution and pathergy, containing immature hematopoietic cells resembling circulating blast cells.

Findings:

  • The described cutaneous eruption in infants with DS and hematologic abnormalities possesses unique clinical and histopathologic characteristics.
  • Resolution of the rash correlates with the subsidence of the underlying hematologic disorder, often occurring without specific treatment.

Implications:

  • Recognizing this specific eruption may improve diagnostic accuracy in newborns with Down syndrome and hematologic abnormalities.
  • Further research is needed to determine if this cutaneous manifestation serves as a prognostic indicator for the future development of leukemia in these infants.
Abstract

Related Concept Videos

Meiosis I01:49

Meiosis I

Meiosis is a carefully orchestrated set of cell divisions, the goal of which—in humans—is to produce haploid sperm or eggs, each containing half the number of chromosomes present in somatic cells elsewhere in the body. Meiosis I is the first such division, and involves several key steps, among them: condensation of replicated chromosomes in diploid cells; the pairing of homologous chromosomes and their exchange of information; and finally, the separation of homologous chromosomes by a...
Disorders of Leukocytes01:27

Disorders of Leukocytes

Leukocyte disorders can lead to either leukopenia, characterized by an abnormally low leukocyte count, or leukocytosis, marked by a very high leukocyte number.
Leukopenia may result from bone marrow disorders, autoimmune diseases, and infectious diseases. For example, conditions such as multiple myeloma and aplastic anemia can impair the bone marrow's ability to produce adequate leukocytes. Similarly, autoimmune diseases like lupus and viral infections such as HIV can prompt the immune system...
Immunodeficiency Diseases01:25

Immunodeficiency Diseases

Immunodeficiency disorders are conditions in which the immune system's ability to fight infectious disease and cancer is compromised or entirely absent. The immune system comprises a complex network of cells, tissues, and organs that work together to protect the body from potentially harmful invaders. When this system is deficient or not functioning properly, it leaves the body susceptible to infections, diseases, or other complications.
There are three main causes of immunodeficiency disorders...
Cytomegalovirus Disease01:27

Cytomegalovirus Disease

Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
Respiratory Syncytial Virus Disease01:29

Respiratory Syncytial Virus Disease

Human respiratory syncytial virus (RSV) is a widespread pathogen that primarily targets infants and young children but also poses a serious health risk to elderly and immunocompromised individuals. Belonging to the Pneumoviridae family, RSV is a negative-sense, single-stranded RNA virus within the Pneumovirus genus. Its global health burden is significant, with millions of cases annually resulting in hospitalizations and mortality, particularly in resource-limited settings. Although most...
Cryptococcal Meningitis01:27

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...