Certified Extremely Low Birth Weight (C-ELBW) Practice Exam

What is the characteristic skin appearance for neonates with CRS?

Blueberry muffin appearance Mottled skin Erythema toxicum Petechiae on face and trunk

Correct Answer:

Blueberry muffin appearance

Explanation:

Congenital rubella syndrome can cause extramedullary hematopoiesis that leads to blue-purple, non-blanching papules scattered over the newborn’s skin, giving a blueberry muffin appearance. This distinctive rash arises early, at birth or soon after, and is a classic sign associated with TORCH infections including rubella. In CRS, you may also see other features like heart defects (such as PDA), cataracts, and sensorineural deafness, but the blueberry muffin skin eruption is the hallmark clue. Other common newborn rashes, like erythema toxicum or cutis marmorata, are not specific to CRS and don’t have the same diagnostic implication.

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