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Subcutaneous fat necrosis of the newborn

February 20, 2024

Subcutaneous fat necrosis of the newborn is a rare form of lobular panniculitis occurring in newborns that is usually self-remitting and non-recurring. Proposed causes include perinatal stress, local trauma, hypoxia and hypothermia, though the exact cause is unknown. It has been suggested that the brown fat seen in newborns is more sensitive to hypoxic injury than fat seen in adults, and that such hypoxia, usually in the context of a complicated birth, leads to the fat necrosis. Complications can include hypercalcemia, hyperlipidemia, dehydration, hypoglycemia, seizures, vomiting, constipation, and thrombocytopenia, and can present months after the onset of SCFN symptoms.[1][2]: 490 [3]

Subcutaneous fat necrosis of the newborn
Other namesSCFN or SFN
SpecialtyPediatrics 

Signs and symptoms edit

Subcutaneous fat necrosis of the newborn (SCFN) occurs in full-term newborns usually in the first six weeks of life as indurated plaques or erythematous to violaceous nodules on the cheeks, back, buttocks, or proximal extremities. Usually, the abdomen and chest are unaffected.[4] There has been a case report of SCFN with localized scalp alopecia covering an erythematous nodule.[5] Tenderness is common in lesions.[6]

About 50% of newborns with subcutaneous fat necrosis of the newborn (SCFN) experience hypercalcemia, a potentially fatal consequence.[7] Some infants with SCFN experience anemia, hypoglycemia, thrombocytopenia, and elevated triglycerides.[8][9] Rarely, thrombocytosis is seen in infants with SCFN.[10]

Causes edit

Although the exact cause of the newborn's subcutaneous fat necrosis is unknown, several systemic maternal diseases, including preeclampsia and diabetes, as well as asphyxia, hypothermia, meconium aspiration, and obstetric trauma, may act as precipitating factors in the development of SCFN.[7]

Diagnosis edit

A skin biopsy and the clinical presentation must both be taken into account for the most accurate diagnosis.[11] But in order to prevent skin biopsy, ultrasonography examination has been shown to be useful in identifying the newborn's subcutaneous fat necrosis when combined with Doppler blood flow analysis; this usually indicates a subcutaneous high echo signal, either with or without calcifications.[12]

See also edit

References edit

  1. ^ Matar, Marla M. (2021). "A Case Report and Anesthetic Considerations in Subcutaneous Fat Necrosis of the Newborn". A&A Practice. 15 (3): e01422. doi:10.1213/XAA.0000000000001422. PMID 33684082. S2CID 232160504.
  2. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
  3. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  4. ^ "UpToDate". UpToDate. Retrieved February 17, 2024.
  5. ^ Xu, Ziyang; Rubin, Adam I.; Oboite, Michelle (June 18, 2021). "Subcutaneous fat necrosis of the newborn presenting as circular alopecia: a novel presentation". Pediatric Dermatology. Wiley. 38 (4): 982–983. doi:10.1111/pde.14664. ISSN 0736-8046. PMID 34145911. S2CID 235481677.
  6. ^ Mahé, E.; Girszyn, N.; Hadj-Rabia, S.; Bodemer, C.; Hamel-Teillac, D.; De Prost, Y. (2007). "Subcutaneous fat necrosis of the newborn: a systematic evaluation of risk factors, clinical manifestations, complications and outcome of 16 children". British Journal of Dermatology. Oxford University Press (OUP). 156 (4): 709–715. doi:10.1111/j.1365-2133.2007.07782.x. ISSN 0007-0963. PMID 17493069. S2CID 29283658.
  7. ^ a b Stefanko, Nicole S.; Drolet, Beth A. (September 6, 2018). "Subcutaneous fat necrosis of the newborn and associated hypercalcemia: A systematic review of the literature". Pediatric Dermatology. Wiley. 36 (1): 24–30. doi:10.1111/pde.13640. ISSN 0736-8046. PMID 30187956.
  8. ^ Del Pozzo-Magaña, Blanca R.; Ho, Nhung (August 30, 2016). "Subcutaneous Fat Necrosis of the Newborn: A 20-Year Retrospective Study". Pediatric Dermatology. Wiley. 33 (6). doi:10.1111/pde.12973. ISSN 0736-8046. S2CID 44286466.
  9. ^ Tran, Julie Thao; Sheth, Anita P. (2003). "Complications of Subcutaneous Fat Necrosis of the Newborn: A Case Report and Review of the Literature". Pediatric Dermatology. Wiley. 20 (3): 257–261. doi:10.1046/j.1525-1470.2003.20315.x. ISSN 0736-8046. PMID 12787278. S2CID 26678688.
  10. ^ Sahni, Mitali; Patel, Pooja; Muthukumar, Akila (February 22, 2020). "Severe Thrombocytosis in a Newborn with Subcutaneous Fat Necrosis and Maternal Chorioamnionitis". Case Reports in Hematology. Hindawi Limited. 2020: 1–3. doi:10.1155/2020/5742394. ISSN 2090-6560. PMC 7056997. PMID 32148979.
  11. ^ Fajgenbaum, Kristen; Zeitany, Alexandra; Googe, Paul B.; Morrell, Dean S.; McShane, Diana (July 9, 2018). "Firm, Indurated Plaques After Therapeutic Hypothermia". Clinical Pediatrics. SAGE Publications. 57 (12): 1468–1471. doi:10.1177/0009922818785992. ISSN 0009-9228.
  12. ^ Tognetti, Linda; Filippou, Georgios; Bertrando, Sara; Picerno, Valentina; Buonocore, Giuseppe; Frediani, Bruno; Fimiani, Michele; Rubegni, Pietro (December 10, 2014). "Subcutaneous Fat Necrosis in a Newborn after Brief Therapeutic Hypothermia: Ultrasonographic Examination". Pediatric Dermatology. Wiley. 32 (3): 427–429. doi:10.1111/pde.12454. ISSN 0736-8046. PMID 25491115. S2CID 29137741.

Further reading edit

  • Lara, Leire González; Villa, Asunción Vicente; Rivas, María Mercedes Otero; Capella, Mariona Sunol; Prada, Fredy; Enseñat, María Antonia González (2017). "Subcutaneous Fat Necrosis of the Newborn: Report of Five Cases". Pediatrics & Neonatology. Elsevier BV. 58 (1): 85–88. doi:10.1016/j.pedneo.2014.06.010. ISSN 1875-9572. PMID 28237247.
  • Mitra, Subhabrata; Dove, Jennifer; Somisetty, Sateesh Kumar (2011-02-12). "Subcutaneous fat necrosis in newborn—an unusual case and review of literature". European Journal of Pediatrics. Springer Science and Business Media LLC. 170 (9): 1107–1110. doi:10.1007/s00431-011-1405-x. ISSN 0340-6199. PMID 21318229. S2CID 23109123.

External links edit

  • DermNet
  • StatPearls

February 20, 2024
subcutaneous, necrosis, newborn, rare, form, lobular, panniculitis, occurring, newborns, that, usually, self, remitting, recurring, proposed, causes, include, perinatal, stress, local, trauma, hypoxia, hypothermia, though, exact, cause, unknown, been, suggeste. Subcutaneous fat necrosis of the newborn is a rare form of lobular panniculitis occurring in newborns that is usually self remitting and non recurring Proposed causes include perinatal stress local trauma hypoxia and hypothermia though the exact cause is unknown It has been suggested that the brown fat seen in newborns is more sensitive to hypoxic injury than fat seen in adults and that such hypoxia usually in the context of a complicated birth leads to the fat necrosis Complications can include hypercalcemia hyperlipidemia dehydration hypoglycemia seizures vomiting constipation and thrombocytopenia and can present months after the onset of SCFN symptoms 1 2 490 3 Subcutaneous fat necrosis of the newbornOther namesSCFN or SFNSpecialtyPediatrics Contents 1 Signs and symptoms 2 Causes 3 Diagnosis 4 See also 5 References 6 Further reading 7 External linksSigns and symptoms editSubcutaneous fat necrosis of the newborn SCFN occurs in full term newborns usually in the first six weeks of life as indurated plaques or erythematous to violaceous nodules on the cheeks back buttocks or proximal extremities Usually the abdomen and chest are unaffected 4 There has been a case report of SCFN with localized scalp alopecia covering an erythematous nodule 5 Tenderness is common in lesions 6 About 50 of newborns with subcutaneous fat necrosis of the newborn SCFN experience hypercalcemia a potentially fatal consequence 7 Some infants with SCFN experience anemia hypoglycemia thrombocytopenia and elevated triglycerides 8 9 Rarely thrombocytosis is seen in infants with SCFN 10 Causes editAlthough the exact cause of the newborn s subcutaneous fat necrosis is unknown several systemic maternal diseases including preeclampsia and diabetes as well as asphyxia hypothermia meconium aspiration and obstetric trauma may act as precipitating factors in the development of SCFN 7 Diagnosis editA skin biopsy and the clinical presentation must both be taken into account for the most accurate diagnosis 11 But in order to prevent skin biopsy ultrasonography examination has been shown to be useful in identifying the newborn s subcutaneous fat necrosis when combined with Doppler blood flow analysis this usually indicates a subcutaneous high echo signal either with or without calcifications 12 See also editPancreatic panniculitis PanniculitisReferences edit Matar Marla M 2021 A Case Report and Anesthetic Considerations in Subcutaneous Fat Necrosis of the Newborn A amp A Practice 15 3 e01422 doi 10 1213 XAA 0000000000001422 PMID 33684082 S2CID 232160504 James William D Berger Timothy G et al 2006 Andrews Diseases of the Skin clinical Dermatology Saunders Elsevier ISBN 978 0 7216 2921 6 Rapini Ronald P Bolognia Jean L Jorizzo Joseph L 2007 Dermatology 2 Volume Set St Louis Mosby ISBN 978 1 4160 2999 1 UpToDate UpToDate Retrieved February 17 2024 Xu Ziyang Rubin Adam I Oboite Michelle June 18 2021 Subcutaneous fat necrosis of the newborn presenting as circular alopecia a novel presentation Pediatric Dermatology Wiley 38 4 982 983 doi 10 1111 pde 14664 ISSN 0736 8046 PMID 34145911 S2CID 235481677 Mahe E Girszyn N Hadj Rabia S Bodemer C Hamel Teillac D De Prost Y 2007 Subcutaneous fat necrosis of the newborn a systematic evaluation of risk factors clinical manifestations complications and outcome of 16 children British Journal of Dermatology Oxford University Press OUP 156 4 709 715 doi 10 1111 j 1365 2133 2007 07782 x ISSN 0007 0963 PMID 17493069 S2CID 29283658 a b Stefanko Nicole S Drolet Beth A September 6 2018 Subcutaneous fat necrosis of the newborn and associated hypercalcemia A systematic review of the literature Pediatric Dermatology Wiley 36 1 24 30 doi 10 1111 pde 13640 ISSN 0736 8046 PMID 30187956 Del Pozzo Magana Blanca R Ho Nhung August 30 2016 Subcutaneous Fat Necrosis of the Newborn A 20 Year Retrospective Study Pediatric Dermatology Wiley 33 6 doi 10 1111 pde 12973 ISSN 0736 8046 S2CID 44286466 Tran Julie Thao Sheth Anita P 2003 Complications of Subcutaneous Fat Necrosis of the Newborn A Case Report and Review of the Literature Pediatric Dermatology Wiley 20 3 257 261 doi 10 1046 j 1525 1470 2003 20315 x ISSN 0736 8046 PMID 12787278 S2CID 26678688 Sahni Mitali Patel Pooja Muthukumar Akila February 22 2020 Severe Thrombocytosis in a Newborn with Subcutaneous Fat Necrosis and Maternal Chorioamnionitis Case Reports in Hematology Hindawi Limited 2020 1 3 doi 10 1155 2020 5742394 ISSN 2090 6560 PMC 7056997 PMID 32148979 Fajgenbaum Kristen Zeitany Alexandra Googe Paul B Morrell Dean S McShane Diana July 9 2018 Firm Indurated Plaques After Therapeutic Hypothermia Clinical Pediatrics SAGE Publications 57 12 1468 1471 doi 10 1177 0009922818785992 ISSN 0009 9228 Tognetti Linda Filippou Georgios Bertrando Sara Picerno Valentina Buonocore Giuseppe Frediani Bruno Fimiani Michele Rubegni Pietro December 10 2014 Subcutaneous Fat Necrosis in a Newborn after Brief Therapeutic Hypothermia Ultrasonographic Examination Pediatric Dermatology Wiley 32 3 427 429 doi 10 1111 pde 12454 ISSN 0736 8046 PMID 25491115 S2CID 29137741 Further reading editLara Leire Gonzalez Villa Asuncion Vicente Rivas Maria Mercedes Otero Capella Mariona Sunol Prada Fredy Ensenat Maria Antonia Gonzalez 2017 Subcutaneous Fat Necrosis of the Newborn Report of Five Cases Pediatrics amp Neonatology Elsevier BV 58 1 85 88 doi 10 1016 j pedneo 2014 06 010 ISSN 1875 9572 PMID 28237247 Mitra Subhabrata Dove Jennifer Somisetty Sateesh Kumar 2011 02 12 Subcutaneous fat necrosis in newborn an unusual case and review of literature European Journal of Pediatrics Springer Science and Business Media LLC 170 9 1107 1110 doi 10 1007 s00431 011 1405 x ISSN 0340 6199 PMID 21318229 S2CID 23109123 External links editDermNet StatPearls Retrieved from https en wikipedia org w index php title Subcutaneous fat necrosis of the newborn amp oldid 1208525018, wikipedia, wiki, book, books, library,

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