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A 3-day-old male neonate presented with rapidly worsening purplish skin lesions. He was born via normal vaginal delivery, was well at birth and received vitamin K prophylaxis. On day 3, he exhibited irritability and a low-grade fever, as well as skin lesions. Examination revealed an inconsolable infant with a rectal temperature of 38.2°C. Multiple dark purple, non-raised, non-blanching skin lesions were noted: one on the right lower back measuring approximately 3×3 cm with irregular borders ( figure 1), another on the left knee surrounded by a lighter-coloured halo (online supplemental figure 1) and a third on the dorsal aspect of the left foot. The rest of the examination was unremarkable.