Cutaneous leukemia is characterized by red or purple slightly elevated papules or nodules; patients with cutaneous myelofibrosis may also develop red or purple slightly elevated papules or nodules. Cutaneous leukemia is a malignancy of the white blood cells in the blood and is characterized by diffuse infiltration of the bone marrow by immature leukocytes and abnormal numbers of immature leukocytes in the blood. In addition, immature leukocytes often infiltrate extensively the liver, spleen, lymph nodes and other organs, including the skin. Cutaneous myelofibrosis, also known as cutaneous extramedullary hematopoiesis, is a chronic myeloproliferative disease. So how are red or purple, slightly elevated papules or nodules diagnosed? Here’s what you need to know. The diagnosis of red or purple, slightly elevated papules or nodules is that the papules may fuse into plaques and bleeding damage may occur. Leukemic gingivitis occurs in 2% to 4% of patients. Hemorrhagic purpura rash and blueberry muffin syndrome are seen in neonates. Hemorrhagic purpura is characterized by a small pale red macular rash on the palmoplantar region of the newborn without specific clinical disease. The rash is a residual damage from physiological dermal red blood cell growth during embryonic development. The slightly elevated purplish red or dark blue papules that appear during the postnatal period in newborns with purple and black berry muffin syndrome usually resolve within 4 to 6 weeks.