[Skin manifestations revealing monocytic leukemia. A case report]

A three-month-old developed a deep nodule over the elbow, then two weeks later additional nodules over the trunk with enlargement of the liver and spleen. Examination of the bone marrow established the diagnosis of monocytic leukemia. Acute monocytic leukemia is the most common leukemia in infants. Skin lesions, visible as red, brown or purple nodules ("blueberry muffin lesions") and confluent areas of purpura are common and may occur as the first manifestations of the disease. These skin lesions are not specific of leukemia and other diagnoses should be considered including histiocytosis, neuroblastoma, and skin erythropoiesis (in Torch syndrome, hemolytic disease of the newborn, hereditary spherocytosis, and twin-to-twin transfusion syndrome).