1
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Bao E, Villavisanis DF, Ibelli TJ, Levy L, Taub PJ. Subcutaneous fat necrosis of the newborn: A systematic review of surgical management and outcomes. J Plast Reconstr Aesthet Surg 2024; 91:293-301. [PMID: 38442509 DOI: 10.1016/j.bjps.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/07/2023] [Accepted: 02/04/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Subcutaneous fat necrosis of the newborn (SCFN) is a rare form of panniculitis manifesting as erythematous plaques or nodules at sites of brown fat in neonates. Surgical management may be indicated in severe cases; however, there is a paucity of literature compiling presentations and outcomes of these surgical patients. METHODS The authors performed a systematic review, in consultation with a licensed librarian, on MEDLINE and Embase for studies including patients with SCFN who were surgically managed. RESULTS The search strategy generated 705 results, among which 213 (30.2%) were excluded for lack of discussion on surgical management. Twenty-two studies discussed surgical management of SCFN in 26 patients, but in 6 of these studies the patients were not surgically managed. Ultimately, 16 articles with 16 patients who were surgically managed were included in the study. Average age at diagnosis was 11.8 ± 9.8 days; average age at surgery was 39.5 ± 70.4 days. The most common etiologies were "unknown" (6, 37.5%), therapeutic hypothermia (4, 25.0%), and birth complications (4, 25.0%). Patients harbored nodules on the back (14, 87.5%), upper extremities (7, 43.8%), lower extremities (7, 43.8%), buttocks (5, 31.3%), and head or neck (3, 18.8%). Linear regression models revealed the presence of back lesions and predicted concomitant medical complications (β = 2.71, p = 0.021). CONCLUSIONS Patients undergoing surgical management for SCFN most commonly harbor lesions on the back and extremities that are secondary to therapeutic hypothermia or of unknown origin. Reporting of additional cases is needed to further elucidate surgical management and outcomes.
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Affiliation(s)
- Eric Bao
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dillan F Villavisanis
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Taylor J Ibelli
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lior Levy
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Peter J Taub
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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2
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Restrepo R, Inarejos Clemente EJ, Corral G, Mas TR, Fenlon EP, Jaramillo D. Subcutaneous fat necrosis of the newborn: a pictorial essay of an under-recognized entity. Pediatr Radiol 2023; 53:313-323. [PMID: 36151218 DOI: 10.1007/s00247-022-05509-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/01/2022] [Accepted: 09/01/2022] [Indexed: 02/04/2023]
Abstract
Subcutaneous fat necrosis of the newborn is a self-limited disorder predominantly affecting full-term and post-term neonates during the first 6 weeks after birth. Subcutaneous fat necrosis can be focal or multifocal and affect one or both sides with a predilection for areas of pressure in certain anatomical areas. Subcutaneous fat necrosis of the newborn is associated with perinatal asphyxia and other neonatal and maternal risk factors. Subcutaneous fat necrosis of the newborn presents as a self-limited area of dermal edema followed by indurated subcutaneous plaques, or nontender and mobile nodules, sometimes with skin discoloration [1-3]. The diagnosis is based on the child's history and physical examination, but when in doubt, imaging is helpful. US is the imaging modality of choice to confirm the diagnosis of subcutaneous fat necrosis of the newborn because it provides the best resolution of superficial lesions, requires no sedation and lacks ionizing radiation. US can also help evaluate and characterize other pathologies affecting the superficial subcutaneous soft tissues at this age. Familiarity with subcutaneous fat necrosis of the newborn is important to make a prompt and precise diagnosis and avoid unnecessary imaging tests or invasive procedures.
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Affiliation(s)
- Ricardo Restrepo
- Department of Radiology, Nicklaus Children's Hospital, Miami, FL, USA
| | | | - Gonzalo Corral
- Department of Radiology, Hospital Exequiel González Cortés, Santiago, Chile
| | - Thomas R Mas
- Ross University School of Medicine, Miramar, FL, USA
| | - Edward P Fenlon
- Department of Radiology, Columbia University Medical Center, 622 West 168th St., New York, NY, 10032, USA
| | - Diego Jaramillo
- Department of Radiology, Columbia University Medical Center, 622 West 168th St., New York, NY, 10032, USA.
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3
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Elmoghanni Y, Aldhafer A, Khalaf M, Cipe F, Komala G, Saleem T, Yavuz S. Subcutaneous Fat Necrosis of the Newborn After Whole-Body Cooling for Birth Asphyxia. Cureus 2023; 15:e34521. [PMID: 36879717 PMCID: PMC9984657 DOI: 10.7759/cureus.34521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Therapeutic hypothermia (TH) is a challenging treatment for a neonate who suffers from hypoxic-ischemic encephalopathy. It has been shown to improve neurodevelopmental outcomes and survival in infants with moderate-to-severe hypoxic-ischemic encephalopathy. However, it has severe adverse effects such as subcutaneous fat necrosis (SCFN). SCFN is a rare disorder that affects term neonates. It is a self-limited disorder but can have severe complications such as hypercalcemia, hypoglycemia, metastatic calcifications, and thrombocytopenia. In this case report, we present a term newborn who developed SCFN after whole-body cooling.
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Affiliation(s)
- Yamen Elmoghanni
- Pediatrics, Al Qassimi Women's and Children's Hospital, Sharjah, ARE
| | - Asma Aldhafer
- Pediatrics, Al Qassimi Women's and Children's Hospital, Sharjah, ARE
| | - Mona Khalaf
- Pediatrics, Al Qassimi Women's and Children's Hospital, Sharjah, ARE
| | - Funda Cipe
- Pediatrics, Al Qassimi Women's and Children's Hospital, Sharjah, ARE
| | | | - Tausif Saleem
- Histopathology, Sheikh Khalifa Medical City, Abu Dhabi, ARE
| | - Sinan Yavuz
- Pediatrics, Al Qassimi Women's and Children's Hospital, Sharjah, ARE
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4
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Frank L, Brandt S, Wabitsch M. Subcutaneous fat necrosis in newborns: a systematic literature review of case reports and model of pathophysiology. Mol Cell Pediatr 2022; 9:18. [PMID: 36427118 PMCID: PMC9700527 DOI: 10.1186/s40348-022-00151-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Subcutaneous fat necrosis of the newborn (SCFN) is a rare disease occurring in the first days of life. Characteristically, the infants show hard nodules in subcutaneous tissue, purple or erythematous in color and appear on the upper back, cheeks, buttocks and limbs. In most cases, SCFN is a self-limiting disease, as the nodules disappear in up to 6 months. A severe complication associated with SCFN is hypercalcaemia. Pathophysiological mechanisms causing SCFN or associated hypercalcaemia are not fully understood yet. METHODS A systematic literature research including the six biggest databases for medical research has been used to identify all published case reports of SCFN. N = 206 publications has been identified containing n = 320 case reports. All cases have been classified into four subgroups (depending on reported serum-calcium-level): hypercalcaemia, normocalcaemia, hypocalcaemia or no information given. Reported maternal factors, birth characteristics, details about SCFN, diagnostics, therapy and long-term observations have been extracted from publications. RESULTS This is the first systematic literature research that summed up all published cases of SCFN from 1948 up to 2018. Information about serum calcium level was given in 64.3% of the cases. From those, the majority showed hypercalcaemia (70.5%) (normocalcaemia 25.1%, hypocalcemia 4.3%). 89.3% of newborns with hypercalcaemia showed suppressed levels of the parathormone. Maternal gestational diabetes, maternal hypertensive diseases during pregnancy, macrosomia (> 4000g), asphyxia and therapeutic hypothermia are risk factors for SCFN. Histological findings showed a granulomatous inflammation in 98% of cases. CONCLUSION We identified that maternal, birth characteristics and therapeutic measures are probably risk factors for SCFN. These risk factors should be taken into account within the care of neonates.
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Affiliation(s)
- Leonie Frank
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
- Department of Orthopaedics and Trauma Surgery, Oberschwaben Clinic Wangen im Allgäu, Wangen im Allgäu, Germany
| | - Stephanie Brandt
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany.
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5
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Bentivegna K, Grant-Kels JM, Livingston N. Cutaneous Mimics of Child Abuse & Neglect: Part II. J Am Acad Dermatol 2022; 87:519-531. [PMID: 35339589 DOI: 10.1016/j.jaad.2021.12.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/06/2021] [Accepted: 12/22/2021] [Indexed: 11/17/2022]
Abstract
Given that some cutaneous mimics of child abuse result from rare disease, they may be more prone to misdiagnosis. For possible child abuse cases in which diagnosis remains uncertain at time of initial dermatologic evaluation, it is important that dermatologists are prepared to distinguish true dermatologic conditions in cases of ambiguous skin findings. Additionally, this review will aid clinicians in recognizing the possibility of concurrent true dermatologic disease and skin findings related to abuse with the acknowledgement that they are not mutually exclusive. Proper recognition of mimics of abuse may prevent unnecessary stress and child protective service investigation.
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Affiliation(s)
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut; Department of Dermatology, University of Florida, Gainesville, Florida.
| | - Nina Livingston
- Department of Pediatrics, University of Connecticut School of Medicine, Connecticut Children's Medical Center, Hartford, Connecticut
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6
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Mehta S, Gupta NP, Batra A, Sharma R. Subcutaneous fat necrosis in an infant with hypoxic ischaemic encephalopathy stage 3: an uncommon association. BMJ Case Rep 2021; 14:14/7/e237933. [PMID: 34321259 PMCID: PMC8319971 DOI: 10.1136/bcr-2020-237933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Subcutaneous fat necrosis (SCFN) is inflammation and necrosis of adipose tissue associated with hypoxia and hypothermia. It leads to various metabolic abnormalities, of which the most dreaded is hypercalcaemia. We report a case of a 7-week-old boy with history of birth asphyxia (hypoxic ischaemic encephalopathy stage 3) who presented to us with features suggestive of hypercalcaemia with bilateral nephrocalcinosis. On examination, there were multiple subcutaneous nodules on both arms. Evaluation revealed suppressed parathyroid activity along with low levels of 25(OH)vitamin D3 and elevated 1,25-dihydroxyvitamin D3 Skin biopsy confirmed the diagnosis of SCFN. He was managed with intravenous fluids, single dose of intravenous furosemide and oral prednisolone. Hypercalcaemia responded within 14 days of admission, prednisolone was tapered and stopped in a month. SCFN, in our case, can be attributed to the underlying perinatal asphyxia along with use of therapeutic hypothermia. Through this case, we wish to sensitise practicing neonatologists for the need of screening and early identification of these abnormalities, which if missed can be fatal.
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Affiliation(s)
- Sonalika Mehta
- Pediatrics, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
| | | | - Anil Batra
- Neonatology, Madhukar Rainbow Children's Hospital, Delhi, India
| | - Rashmi Sharma
- Skin and Venereal Diseases, Madhukar Rainbow Children's Hospital, Delhi, India
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7
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Chrysaidou K, Sargiotis G, Karava V, Liasis D, Gourvas V, Moutsanas V, Christoforidis A, Stabouli S. Subcutaneous Fat Necrosis and Hypercalcemia with Nephrocalcinosis in Infancy: Case Report and Review of the Literature. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8050374. [PMID: 34065153 PMCID: PMC8151818 DOI: 10.3390/children8050374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 11/18/2022]
Abstract
Subcutaneous fat necrosis is an uncommon benign panniculitis affecting more commonly full-term newborns. It has been associated with birth asphyxia and meconium aspiration, as well as therapeutic hypothermia. Although the prognosis is generally favorable, complications such as hypercalcemia, thrombocytopenia, hypoglycemia and hypertriglyceridemia may complicate its course. The most serious complication is hypercalcemia that may reach life threatening levels and can be associated with nephrocalcinosis. We thereby describe a case of subcutaneous fat necrosis after therapeutic hypothermia, which presented with late-onset refractory severe hypercalcemia and persistent nephrocalcinosis during the follow up of the patient. Due to the risk of the development of chronic kidney disease, we highlight the importance of careful monitoring of hypercalcemia and review the literature of subcutaneous fat necrosis related to nephrocalcinosis.
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Affiliation(s)
- Katerina Chrysaidou
- 1st Department of Pediatrics, Aristotle University of Thessaloniki, Hippokratio General Hospital Thessaloniki, 54642 Thessaloniki, Greece; (K.C.); (G.S.); (V.K.); (A.C.)
- Department of Pediatrics, St Luke’s Hospital, Panorama, 55236 Thessaloniki, Greece; (D.L.); (V.G.)
| | - Georgios Sargiotis
- 1st Department of Pediatrics, Aristotle University of Thessaloniki, Hippokratio General Hospital Thessaloniki, 54642 Thessaloniki, Greece; (K.C.); (G.S.); (V.K.); (A.C.)
| | - Vasiliki Karava
- 1st Department of Pediatrics, Aristotle University of Thessaloniki, Hippokratio General Hospital Thessaloniki, 54642 Thessaloniki, Greece; (K.C.); (G.S.); (V.K.); (A.C.)
| | - Dimitrios Liasis
- Department of Pediatrics, St Luke’s Hospital, Panorama, 55236 Thessaloniki, Greece; (D.L.); (V.G.)
| | - Victor Gourvas
- Department of Pediatrics, St Luke’s Hospital, Panorama, 55236 Thessaloniki, Greece; (D.L.); (V.G.)
| | | | - Athanasios Christoforidis
- 1st Department of Pediatrics, Aristotle University of Thessaloniki, Hippokratio General Hospital Thessaloniki, 54642 Thessaloniki, Greece; (K.C.); (G.S.); (V.K.); (A.C.)
| | - Stella Stabouli
- 1st Department of Pediatrics, Aristotle University of Thessaloniki, Hippokratio General Hospital Thessaloniki, 54642 Thessaloniki, Greece; (K.C.); (G.S.); (V.K.); (A.C.)
- Correspondence:
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8
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Al-Ghamdi WM, Milyani AA, Al-Agha AE. Extensive subcutaneous fat necrosis complicated by neonatal hypercalcaemia. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021081. [PMID: 33944856 PMCID: PMC8142782 DOI: 10.23750/abm.v92is1.8469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 07/13/2019] [Indexed: 11/23/2022]
Abstract
subcutaneous fat necrosis is a benign and often self-limiting inflammatory disorder experienced by newborns who were exposed to perinatal stress in the form of asphyxia, hypothermia, cord prolapse, and/or sepsis. lesions are usually benign and self-limiting, with complete resolution anticipated within a few weeks up to 6 months. they can be accompanied by multiple complications. of which the most significant and of life-threatening potential is neonatal hypocalcaemia. if not timely anticipated and adequately treated, the patient might deteriorate due to dehydration and acute renal failure. symptoms of neonatal hypercalcaemia can be variable in this age group, transcending from a nonspecific presentation of irritability, poor feeding, vomiting and constipation to the well-recognised polyuria, polydipsia, and dehydration. therapeutic options are provided through initial hyperrehydration and calcium wasting diuretics, switching feeds to a low calcium and vitamin D formula milk, institution of systemic steriods and if necessary, inititating bisphosphonate therapy in hypercalcaemia that is severe, recalcitrant to the previously mentioned treatment modalities, and/or when a rapid decrease in serum calcium levels is desired. in this report we describe a case of a 10 month old female infant with moderate neonatal hypercalcaemia as a complication of extensive SCFN manifestating by the age of 10 days and persisting into a prolonged clinical course of up to 9 months until most of the lesions were resolved.
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9
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Matar MM. A Case Report and Anesthetic Considerations in Subcutaneous Fat Necrosis of the Newborn. A A Pract 2021; 15:e01422. [PMID: 33684082 DOI: 10.1213/xaa.0000000000001422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Subcutaneous fat necrosis of the newborn (SCFN) is an uncommon, self-limiting panniculitis generally diagnosed in the first few weeks of extrauterine life in term or postterm infants subjected to perinatal physiologic stress. Hallmarks of the process include dramatic hypercalcemia without identifiable cause that may be associated with renal disease, seizures, and death. Herein, we describe the anesthetic approach in an 11-week-old infant, including perioperative laboratory testing, management of hypercalcemia, and intraoperative considerations.
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Affiliation(s)
- Marla M Matar
- From the Department of Pediatrics and Anesthesiology, University of Southern California
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California
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10
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Jabbour AJ, Warrier R, Kretschmar P. Multiple Enlarging Masses and Failure to Thrive in Infant With Sickle Cell Trait. Clin Pediatr (Phila) 2021; 60:131-133. [PMID: 33167686 DOI: 10.1177/0009922820972201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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11
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Lehrer B, Pronko K, Burek AG. Ulcerated Arm Lesion in a 10-day-old Girl. Pediatr Rev 2021; 42:S93-SS96. [PMID: 33386373 DOI: 10.1542/pir.2019-0267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Kyle Pronko
- Medical College of Wisconsin, Milwaukee, WI.,Children's Wisconsin, Milwaukee, WI
| | - Alina G Burek
- Medical College of Wisconsin, Milwaukee, WI.,Children's Wisconsin, Milwaukee, WI
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12
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Kodagali SS, Anantharaman RN. Subcutaneous fat necrosis in a neonate. Arch Dis Child Educ Pract Ed 2019; 104:248-249. [PMID: 29970590 DOI: 10.1136/archdischild-2017-314683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 06/09/2018] [Indexed: 11/03/2022]
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13
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Stefanko NS, Drolet BA. Subcutaneous fat necrosis of the newborn and associated hypercalcemia: A systematic review of the literature. Pediatr Dermatol 2019; 36:24-30. [PMID: 30187956 DOI: 10.1111/pde.13640] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Subcutaneous fat necrosis of the newborn is an uncommon disorder, and although usually benign, associated hypercalcemia can lead to complications such as failure to thrive and renal failure. Many sources suggest screening for hypercalcemia for 6 months following resolution of skin lesions, but little data are available to support this recommendation. This study examines existing published literature to better guide practitioners regarding screening evaluations of asymptomatic patients with subcutaneous fat necrosis. A systematic review of the literature was conducted using a PubMed English literature search. Data from case reports and case series were collected regarding the presence of hypercalcemia and associated complications, birth history, and age of onset/resolution of skin lesions and laboratory abnormalities. Approximately half (51%) of infants reported had hypercalcemia. Most (77%) developed detectable hypercalcemia within 30 days of skin lesion onset, and 95% developed detectable hypercalcemia within 60 days of skin lesion onset. Hypercalcemia was detected in only 4% of patients > 70 days following onset of skin lesions. Seventy-six percent had resolution of hypercalcemia within 4 weeks of detection. Hypercalcemia was more prevalent in full-term vs pre-term infants (P-value = 0.054), and higher birthweight was significantly associated with an increased risk of developing hypercalcemia (P-value = 0.022). Although gestational age trended toward significance, the only statistically significant clinical feature predicting the development of hypercalcemia was higher birthweight. Current recommendations for laboratory monitoring are not evidence-based, and this study provides interim data to guide practitioners until prospective, randomized controlled trials are conducted.
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Affiliation(s)
- Nicole S Stefanko
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Beth A Drolet
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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14
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Abstract
Subcutaneous fat necrosis of newborn is a form of noninfectious panniculitis. It is an uncommon condition and mostly occurs in full-term infants within first weeks of life that have had a significant condition such as hypoxic-ischemic encephalopathy at the time of birth. Subcutaneous fat necrosis of newborn is usually a self-limiting condition but may be associated with hypercalcemia, which may lead to life threatening levels. Hypercalcemia is a significant reason of subcutaneous fat necrosis and needs an intervention involving hyperhydration, calcitonin, diuretics, steroids and sometimes bisphosphonate in resistant cases. Here, we have reported the case of a term infant who developed extensive subcutaneous fat necrosis in the first week of life after significant perinatal hypoxic injury. Her condition was complicated by hypercalcemia resistant to prolonged medical treatment with hyperhydration, diuretic and steroid but eventually the infant responded to high doses of calcitonin.
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Affiliation(s)
- Khouloud A Alsofyani
- Department of Pediatric, Section of Pediatric Critical Care, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. E-mail.
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15
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Aye MS, Mahaseth M, Rozzelle A, Bhagat I, Agarwal P. Newborn With Enlarged Erythematous Mass on Back: Case Report and Review of Medical Literature. Glob Pediatr Health 2018; 5:2333794X18803552. [PMID: 30288394 PMCID: PMC6168720 DOI: 10.1177/2333794x18803552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 08/14/2018] [Accepted: 08/28/2018] [Indexed: 12/02/2022] Open
Abstract
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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Affiliation(s)
- Myo-Sabai Aye
- Wayne State University, Detroit, MI, USA.,Children's Hospital of Michigan, Detroit, MI, USA
| | - Maheshwar Mahaseth
- Wayne State University, Detroit, MI, USA.,Children's Hospital of Michigan, Detroit, MI, USA
| | - Arlene Rozzelle
- Wayne State University, Detroit, MI, USA.,Children's Hospital of Michigan, Detroit, MI, USA
| | - Indira Bhagat
- Wayne State University, Detroit, MI, USA.,Children's Hospital of Michigan, Detroit, MI, USA
| | - Prashant Agarwal
- Wayne State University, Detroit, MI, USA.,Children's Hospital of Michigan, Detroit, MI, USA
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16
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Fajgenbaum K, Zeitany A, Googe PB, Morrell DS, McShane D. Firm, Indurated Plaques After Therapeutic Hypothermia. Clin Pediatr (Phila) 2018; 57:1468-1471. [PMID: 29985047 DOI: 10.1177/0009922818785992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Alexandra Zeitany
- 2 Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Paul B Googe
- 2 Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Dean S Morrell
- 2 Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Diana McShane
- 2 Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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17
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Bilbao NA. Vitamin D Toxicity in Young Breastfed Infants: Report of 2 Cases. Glob Pediatr Health 2017; 4:2333794X17731695. [PMID: 28955720 PMCID: PMC5607921 DOI: 10.1177/2333794x17731695] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 08/08/2017] [Indexed: 11/16/2022] Open
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18
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Rubin G, Spagnut G, Morandi F, Valerio E, Cutrone M. Subcutaneous fat necrosis of the newborn. Clin Case Rep 2015; 3:1017-20. [PMID: 26734138 PMCID: PMC4693698 DOI: 10.1002/ccr3.423] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 09/13/2015] [Accepted: 09/28/2015] [Indexed: 12/02/2022] Open
Abstract
Subcutaneous fat necrosis (SCFN) is a rare fat tissue inflammation of the newborn. Risk factors include cord prolapse, perinatal asphyxia, therapeutic hypothermia, meconium aspiration, and sepsis. When present, hypercalcemia comes with lethargy, hypotonia, irritability, vomiting, polyuria, polydipsia, constipation, and dehydration. Kidney injury must be avoided. SCFN is often completely autoresolutive.
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Affiliation(s)
- Giulia Rubin
- Department of Women and Children's Health Medical School Padua University Hospital Padova Italy
| | - Giulia Spagnut
- Department of Pediatrics "Santa Maria della Misericordia" Hospital Udine University Udine Italy
| | | | - Enrico Valerio
- Department of Women and Children's Health Medical School Padua University Hospital Padova Italy
| | - Mario Cutrone
- Pediatric Dermatology Unit "Dell'Angelo" Hospital Venice Italy
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