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Santiago Guillen-Climent1, Alejandro García Vázquez, Andrea Estébanez

  • 1Servicio de Dermatología, Hospital Clínico Universitario, Valencia. santigc85@gmail.com.

Dermatology Online Journal
|December 20, 2020
PubMed
Summary

Subcutaneous fat necrosis of the newborn is a rare panniculitis affecting newborns, presenting as firm skin plaques. While typically self-limiting, it can lead to serious complications like hypercalcemia that require monitoring.

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Area of Science:

  • Dermatology
  • Neonatology
  • Pathology

Background:

  • Subcutaneous fat necrosis of the newborn (SCFN) is a rare lobular panniculitis.
  • It typically affects term or post-term neonates with a history of perinatal compromise or maternal gestational pathology.

Observation:

  • Cutaneous manifestations include erythematous, indurated subcutaneous plaques and nodules, predominantly on the dorsal region and shoulders.
  • Histopathology reveals lobular panniculitis with lymphohistiocytic infiltrate, fatty necrosis, and characteristic radial needle-shaped crystals in adipocytes.
  • Cutaneous ultrasound shows hyperechoic, avascular subcutaneous tissue, with potential acoustic shadows indicating calcifications.

Findings:

  • Diagnosis is primarily clinical and pathological, with characteristic histopathological findings.

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  • Differential diagnosis includes sclerema neonatorum, post-corticosteroid panniculitis, and other crystal-forming panniculitis.
  • While usually self-limited, potential complications include hypercalcemia, hypoglycemia, hypertriglyceridemia, thrombocytopenia, and anemia.

    • Implications:

    • Early identification and management of complications, particularly hypercalcemia, are crucial during diagnosis and follow-up.
    • Understanding the clinical and pathological features aids in differentiating SCFN from other neonatal skin conditions.
    • Monitoring for metabolic complications is essential for optimal patient outcomes in neonatal subcutaneous fat necrosis.