A 2-week-old neonate born with generalized dark blue to magenta, nonblanchable, indurated, round to oval, hemispheric purpuric papules and plaques ranging from 1 mm to 1 cm. The lesions favored the face, trunk and limbs. There was no identifiable underlying cause.

         The main etiologic factors include congenital infections (rubella, cytomegalovirus, and parvovirus B19), hemolytic disease of the newborn (Rh incompatibility, blood group incompatibility), hereditary spherocytosis, neuroblastoma, rhabdomyosarcoma, Langerhans cell histiocytosis, and congenital leukemia.