The Skin as an Early Expression of Malignancies in the Neonatal Age: A Review of the Literature and a Case Series

Figure 4

A reticulated, maculopapular rash in the lower limb in a term male affected by haemophagocytic lymphohistiocytosis. He presented with fever associated with generalized rash which disappeared in the first week of life and appeared again on 30th day. Blood test analysis showed values indicative of liver failure; blood cell count revealed low platelets values. The abdominal ultrasound scan showed thinly irregular liver parenchyma. Hypoplasia of granulocyte and erythroblastic and megakaryocytic lineages (<5% each) with haematopoietic cell phagocytosis by mature macrophages were present in the bone marrow aspirate. High-dose glucocorticoids, cyclosporine, and etoposide were started. Despite the therapy, there has been gradual deterioration of the clinical condition until coma, respiratory failure, intractable hypotension, and coagulopathy led to death despite intensive vital support.