Violaceous Papules and Macules in a Newborn

REPORT OF A CASE A female infant born with thrombocytopenia, hepatosplenomegaly, jaundice, and a generalized nonblanching violaceous eruption was transferred to The Johns Hopkins Hospital Pediatric Intensive Care Unit, Baltimore, at 8 hours of life for evaluation. The mother was a 35-year-old woman, gravida 1 and para 1, with blood group 0+, a nonreactive serologic test for syphilis, and a normal platelet count and rubella titer. During the fourth month of pregnancy, the mother had a brief febrile, diarrheal illness, which was not further evaluated. Delivery occurred at term, 34 hours after the membranes had ruptured, and was assisted by low forceps. The family history was significant for systemic lupus erythematosus, and there was no family history of bleeding disorders. Physical examination revealed a female infant in no acute distress, who was in the 25th percentile for length, below the fifth percentile for weight, and in the second percentile for