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Vesiculopustular eruptions in a preterm baby with trisomy 21 – it's not always infection
  1. T S Nedungadi,
  2. L Miall
  1. Leeds Teaching Hospitals NHS Trust, Leeds, UK


Transient myeloproliferative disorder (TMD) occurs in about 10% of babies with Down syndrome.1 This condition is important to recognise as 20–30% of babies with Down syndrome who have had TMD go on to develop leukaemia in next 2–3 years.2 TMD may clinically manifest with vesiculopustular eruptions in neonate.3 This is transient and self resolving. This can be mistaken to be due to infective and other causes.

We present a preterm baby (35 weeks gestation) who was diagnosed postnatally with Trisomy 21. He was treated for neonatal jaundice with phototherapy. He developed extensive erythematous vesiculopustular rash on mainly on the face and few on the trunk on Day 7 of life. There was also evidence of crusting of some lesions. Systemic examination was normal. He was empirically initiated on antibiotics and aciclovir.

His peripheral blood film showed a leucoerythroblastosis with raised blasts consistent with a picture of TMD. The blood picture in the following weeks had normalised. The rash also has improved on follow-up.

This is being presented for increasing awareness of this transient condition in the neonatal period due to its future implications and need for close follow-up. There are only few reports of cutaneous manifestation of TMD in preterm neonate with trisomy 21 in literature.

In this we provide differentials to consider and a brief literature review around this transient self resolving condition.

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