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Year : 1995  |  Volume : 61  |  Issue : 3  |  Page : 150-151

Blue rubber bleb naevus

Correspondence Address:
R R Mittal

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Source of Support: None, Conflict of Interest: None

PMID: 20952931

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A 35 year old female had multiple progressive painful, tender, soft, bluish compressible nodules with the feel of rubber nipples. There was no evidence of gastrointestinal haemangiomas or other systemic abnormalities. Histopathologically, cavernous haemangioma with prominent smooth muscle outline proved the clinical diagnosis of blue rubber bleb naevus. Only cutaneous lesions were seen in the patient.

How to cite this article:
Mittal R R, Maninder. Blue rubber bleb naevus. Indian J Dermatol Venereol Leprol 1995;61:150-1

How to cite this URL:
Mittal R R, Maninder. Blue rubber bleb naevus. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2020 Jan 28];61:150-1. Available from: http://www.ijdvl.com/text.asp?1995/61/3/150/4184

  Introduction Top

Blue rubber bleb naevi (BRBN) resemble phlebactesia in appearance with the sensation of dermal herniation. They are progressive, painful, tender, bluish, soft rubbery and compressible haemangiomas which refill promptly.[1][2][3][4][5] They may have excessive sweating over them. They are found more commonly on the trunk and limbs and appear at birth or infancy.1, 5 Associated systemic haemangiomas of the gastrointestinal tract, spleen, liver, stomach, brain, spinal cord, heart and kidney have been reported.[2],[3],[5] BRBN may be associated with chronic anaemia due to gastrointestinal bleeding and are transmitted as an autosomal dominant trait.[3] A case of BRBN in association with Maffucci's syndrome was reported.[4] BRBN may turn malignant over years rather than undergoing spontaneous remission and may have associated musculoskeletal abnormalities.[5]

  Case Report Top

A 35-year-old female had multiple progressive, bluish-purple, soft, crumpled, painful (more at night), tender nodules on the abdomen since infancy. One nodule, 1.2 x 1.5 cm in size, was below the umbilicus. Another nodule, 2.5 x 3 cm in size, was just above the pubes and a third, 0.5 x 1 cm in size, on the right thigh. The others ranged in size from 3 mm to 1 cm and were also bluish and soft. The nodules were compressible, with a sensation of dermal herniation, and emptied partially on milking. There was no excessive sweating over the nodules. There was no clinical evidence of gastrointestinal haemangiomas. General physical and systemic examinations were normal.

Routine investigations including bleeding and clotting time, platelet count, and prothrombin time and index were normal. The fasting blood sugar, liver function tests and X-ray skull and ultrasound examinations for the liver, spleen and kidneys were normal. Histopathology revealed cavernous haemangioma with prominent smooth muscle lining of vessel walls.

  Discussion Top

Only cutaneous lesions can be present in cases of BRBN and a similar case without systemic haemangiomas was reported earlier.[1] It is a rare condition and this may be first case of BRBN in the Indian literature.

  References Top

1.Fine RM, Derbes VJ, Clark WH. Blue rubber bleb nevus. Arch Dermatol 1961;84:802-5.  Back to cited text no. 1    
2.Rice JS, Fischer DS. Blue rubber bleb nevus syndrome. Arch Dermatol 1962;86:503-11.  Back to cited text no. 2  [PUBMED]  
3.Berlyne GM, Berlyne N. Anaemia due to blue rubber bleb nevus disease. Lancet 1960; ii: 1275-7.  Back to cited text no. 3    
4.Sakurane HF, Sugai T, Saito T. The association of Blue rubber bleb nevus and Maffucci's syndrome. Arch Dermatol 1967;95:28-36.  Back to cited text no. 4  [PUBMED]  
5.Atherton DJ. Naevi and other developmental defects. In: Textbook of Dermatology (Champion RH, Burton JL, Ebling FJG, eds). 5th edn. Oxford: Blackwell Scientific Publication, 1992;500-2.  Back to cited text no. 5    


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