G532(P) ‘SCFN’ (subcutaneous fat necrosis) of the newborn – an important differential diagnosis in evaluation for causes of bruise-like skin lesions in a neonate

Subcutaneous fat necrosis of the newborn is an uncommon, transient and self-healing panniculits. This entity generally follows an uncomplicated course, however there are rare and important complications. The authors present a case of a newborn with subcutaneous fat necrosis complicated by hypercalcemia and nephrocalcinosis. The pathogenesis of hypercalcemia is not fully understood and the nephrocalcinosis can evolve to chronic kidney disease. Clinicians should be aware of subcutaneous fat necrosis as a possible risk factor for hypercalcemia and patients should have serial serum and urinary calcium determinations for up to 6 months after the appearance of the skin lesions. The early diagnosis and prompt treatment of hypercalcemia are essential to prevent severe complications. Keywords: Hypercalcemia; Fat Necrosis; Infant, Newborn; Nephrocalcinosis; Subcutaneous Fat.

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Newborn With Enlarged Erythematous Mass on Back: Case Report and Review of Medical Literature

Global Pediatric Health ◽

10.1177/2333794x18803552 ◽

2018 ◽

Vol 5 ◽

pp. 2333794X1880355

Author(s):

Myo-Sabai Aye ◽

Maheshwar Mahaseth ◽

Arlene Rozzelle ◽

Indira Bhagat ◽

Prashant Agarwal

Keyword(s):

Differential Diagnosis ◽

Medical Literature ◽

Malignant Tumors ◽

Subcutaneous Fat ◽

Skin Condition ◽

Benign Tumors ◽

Fat Necrosis ◽

Subcutaneous Fat Necrosis ◽

Skin Nodules ◽

Sclerema Neonatorum

Newborn skin nodules are usually benign and self-resolving skin condition. Differential diagnosis of such lesions include cysts, hemangioma, abscess, cellulitis, sclerema neonatorum, subcutaneous fat necrosis, neurofibromatosis, benign tumors, or malignant tumors such as rhabdomyosarcoma, infantile fibrosarcoma, or neuroblastoma. We report a case of congenital subcutaneous fat necrosis in a 7-day-old baby presenting with multiple erythematous mass on back.

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Subcutaneous fat necrosis of the newborn

BMJ Case Reports ◽

10.1136/bcr-2019-231458 ◽

2019 ◽

Vol 12 (12) ◽

pp. e231458 ◽

Cited By ~ 1

Author(s):

Niamh O' Brien ◽

Breda Hayes

Keyword(s):

Therapeutic Hypothermia ◽

Subcutaneous Fat ◽

Hand Preference ◽

Skin Lesions ◽

Term Infant ◽

Fat Necrosis ◽

Subcutaneous Fat Necrosis ◽

Motor Delay ◽

Full Resolution ◽

Outcome Information

A term infant developed subcutaneous fat necrosis of the newborn (SFNN) 17 days following completion of therapeutic hypothermia for hypoxic ischaemic encephalopathy. Initial calcium was normal, however hypercalcaemia requiring hyperhydration and furosemide developed at 4 weeks. Parathyroid hormone and vitamin D were suppressed. At 13 months, she remains on low calcium formula, and has gross motor delay, central hypotonia and early hand preference. Review of 102 articles yielded 119 SFNN cases. Asphyxia was reported in 78%. Twenty-one per cent had hypoglycaemia. Twenty per cent underwent therapeutic hypothermia. Median onset of skin lesions was day 6 (range: 1–70), with a median duration of 62 days (range: 14–390). Hypercalcaemia developed in 53% (median onset day 28, range: 1–210). Fifty-two per cent of hypercalcaemia was asymptomatic. Outcome information was provided in 106/119 cases; 87% reported a full resolution. Persistent calcinosis was present in 6%. Babies treated with therapeutic hypothermia should be closely monitored for SFNN, and development of hypercalcaemia.

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Subcutaneous fat necrosis of the newborn. A case report

Archives of Dermatology ◽

10.1001/archderm.117.1.36 ◽

1981 ◽

Vol 117 (1) ◽

pp. 36-37 ◽

Cited By ~ 10

Author(s):

T. H. Chen

Keyword(s):

Case Report ◽

Subcutaneous Fat ◽

Fat Necrosis ◽

Subcutaneous Fat Necrosis

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Repeated Occurrence of Skin Necrosis Twice Following Coumarin Intake and Subsequently During Decrease of Vitamin K Dependent Coagulation Factors Associated with Cholestasis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1657270 ◽

1982 ◽

Vol 48 (03) ◽

pp. 245-246 ◽

Cited By ~ 24

Author(s):

V Hofmann ◽

P G Frick

Keyword(s):

Skin Necrosis ◽

Oral Anticoagulants ◽

Subcutaneous Fat ◽

Coagulation Factors ◽

Fat Necrosis ◽

Subcutaneous Fat Necrosis ◽

Skin Changes ◽

Factors Associated ◽

Therapeutic Anticoagulation ◽

Coumarin Necrosis

SummaryA female patient is described who developed skin and subcutaneous fat necrosis on two occasions after intake of acenocoumarol.Several months later identical skin changes occurred during an episode of cholestasis associated with a prolongation of the prothrombin time to an extent comparable with therapeutic anticoagulation; intake of oral anticoagulants could be excluded.This association gives new insights in the pathogenetic mechanisms responsible for the so-called coumarin necrosis and indicates that it may be not due to drug toxicity or allergy.

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