Neuroblastoma is a rare malignancy that may affect newborns and infants. Cutaneous nodules and periorbital purpura (Raccoon eyes) can be a presenting sign of neuroblastoma. The periorbital ecchymoses may be related to obstruction of the palpebral vessels by metastatic tissue in and around the orbits.


With regard to the skin, cutaneous nodules and periorbital purpura (Raccoon eyes) may be presenting signs. Some patients have been described as having firm, blue cutaneous nodules which blanch when rubbed and are surrounded by a halo of erythema.


Referral to a specialist is in order.


A three-year-old boy presented with low-grade fever for two months and bruising around the eyes for two weeks. He also had loss of appetite and gradual weight loss. Indian J Dermatol Venereol Leprol 2012;78:740-1

A newborn presented with multiple, shiny, pinkish, purple fleshy nodules all over the body along with massive hepatomegaly. Dermatology Online Journal 2009;15(11)

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