Korean J Perinatol.  2014 Sep;25(3):184-188. 10.14734/kjp.2014.25.3.184.

A Case of Subcutaneous Fat Necrosis of the Newborn with Hypoglycemia and Meconium Aspiration Syndrome

• Kim TH
• Choi MS
• Chung SH
• Choi YS
• Sim WY
• Bae CW

• KMID: 2280995
• DOI: http://doi.org/10.14734/kjp.2014.25.3.184

Abstract

Subcutaneous fat necrosis of the newborn is a rare, benign disease usually found in full-term infants. It occurs usually in a few weeks after birth, as one or multiple indurated nodules or plaques on the fat pads-rich fraction of the body and disappeared after few weeks to months. Complications such as hypercalcemia, pain, lipid abnormalities (dyslipidemia), renal failure, and subcutaneous atrophy may occur. We report a case of subcutaneous fat necrosis associated with hypoglycemia and meconium aspiration syndrome in the term infant and review the associated literatures.

Keyword

Fat necrosis; Newborn; Hypoglycemia; Meconium aspiration syndrome

MeSH Terms

Atrophy
Fat Necrosis
Humans
Hypercalcemia
Hypoglycemia*
Infant
Infant, Newborn*
Meconium Aspiration Syndrome*
Necrosis*
Parturition
Renal Insufficiency
Subcutaneous Fat*

Figure

• 

  Fig. 1. Large, multiple, erythematous, indurated, smooth swelling on the upper back and left shoulder of the neonate on day 4 of life.

• 

  Fig. 2. Histology of a biopsy showing (A) necrosis and inflammation in subcutaneous tissue (H&E stain ×200), and (B) inflammatory cells with the characteristic needle-shaped clefts (H&E stain, ×400).

Reference

1.Burden AD., Krafchik MB. Subcutaneous fat necrosis of the newborn: a review of 11 cases. Pediatr Dermatol. 1999. 16:384–7.

2.Hogeling M., Meddles K., Berk DR., Bruckner AL., Shimotake TK., Cohen RS, et al. Extensive subcutaneous fat necrosis of the newborn associated with therapeutic hypothermia. Pediatr Dermatol. 2012. 29:59–63.

3.Mitra S., Dove J., Somisetty SK. Subcutaneous fat necrosis in newborn-an unusual case and review of literature. Eur J Pediatr. 2011. 170:1107–10.

4.Bonnemains L., Rouleau S., Sing G., Bouderlique C., Coutant R. Severe neonatal hypercalcemia caused by subcutaneous fat necrosis without any apparent cutaneous lesion. Eur J Pediatr. 2008. 167:1459–61.

5.Mahé E., Girszyn N., Hadj-Rabia S., Bodemer C., Hamel-Teillac D., De Prost Y. Subcutaneous fat necrosis of the newborn: a systematic evaluation of risk factors, clinical manifestations, complications and outcome of 16 children. Br J Dermatol. 2007. 156:709–15.

6.Jeon HS., Lee MI., Ahn DH., Yoo HJ. A case of subcutaneous fat necrosis of the newborn. J Korean Pediatric Soc. 1994. 37:405–9.

7.Hong MA., Oh KC., Ahn SI., Shin HJ., Chang JK., Lee BD, et al. A case of subcutaneous fat necrosis in neonate with meconium aspiration syndrome. J Korean Pediatr Soc. 2002. 45:1422–5.

8.Choi J., Kim JS., Yoon HS., Jung EC., Lee AY., Song KY. A case of generalized subcutaneous fat necrosis of newborn. Korean J Dermatol. 2003. 41:932–5.

9.Yi KS., Cho BS., Bae IH., Lee SY., Jeon MH., Lee OJ, et al. Subcutaneous fat necrosis of the newborn: A case report. J Korean Soc Ultrasound Med. 2007. 26:125–8.

10.Zeb A., Darmstadt GL. Sclerema neonatorum: a review of nomenclature, clinical presentation, histological features, differential diagnoses and management. J Perinatol. 2008. 28:453–60.

11.Tran JT., Sheth AP. Complications of subcutaneous fat necrosis of the newborn: a case report and review of the literature. Pediatr Dermatol. 2003. 20:257–61.

12.Borgia F., De Pasquale L., Cacace C., Meo P., Guarneri C., Can-navo SP. Subcutaneous fat necrosis of the newborn: be aware of hypercalcaemia. J Paediatr Child Health. 2006. 42:316–8.

13.Oswalt GC., Montes LF., Cassady G. Subcutaneous fat necrosis of the newborn. J Cutan Pathol. 1978. 5:193–9.

14.Blake HA., Goyette EM., Lyter CS., Swan H. Subcutaneous fat necrosis complicating hypothermia. J Pediatr. 1955. 46:78–80.

15.Ivy RE., Howard FH. Subcutaneous fat necrosis of the newborn infant; report of a case in an infant born by cesarean section, and with no anoxia. J Pediatr. 1953. 42:600–2.

16.Ladoyanni E., Moss C., Brown RM., Ogboli M. Subcutaneous fat necrosis in a newborn associated with asymptomatic and uncomplicated hypercalcemia. Pediatr Dermatol. 2009. 26:217–9.

17.Akin MA., Akin L., Sarici D., Yilmaz I., Balkanli S., Kurtoglu S. Follow-up during early infancy of newborns diagnosed with subcutaneous fat necrosis. J Clin Res Pediatr Endocrinol. 2011. 3:216–8.

18.Sharata H., Postellon DC., Hashimoto K. Subcutaneous fat necrosis, hypercalcemia, and prostaglandin E. Pediatr Dermatol. 1995. 12:43–7.

19.Finne PH., Sanderud J., Aksnes L., Bratlid D., Aarskog D. Hypercalcemia with increased and unregulated 1,25-dihydro-xyvitamin D production in a neonate with subcutaneous fat necrosis. J Pediatr. 1988. 112:792–4.