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A 25-day-old newborn was admitted to our hospital with a diagnosis of bronchiolitis. During admission, the infant developed violaceous skin lesions with edema in inguinal and axillary regions (Figure). Lesions became ulcerated within 3 to 4 days, with infarcted necrotic areas. Blood tests showed leukopenia (white blood cell count, 2460/μL) with neutropenia (neutrophil count, 220/μL) (to convert both to ×109 per liter, multiply by 0.001). The lesions were biopsied and samples were sent for cultures and histopathological analysis. Intravenous floxacillin was started, followed by surgical debridement due to progression of the major lesions.
Oliveira L, Esteves IC, Prata F, Tapadinhas C, Guerreiro C, Marques JG. Newborn With Unexpected Skin Lesions. JAMA Pediatr. 2014;168(1):91-92. doi:10.1001/jamapediatrics.2013.3440