Follow-up during early infancy of newborns diagnosed with subcutaneous fat necrosis

Abstract

Subcutaneous fat necrosis of the newborn (ScFN) is an uncommon condition caused by generalized and/or local tissue hypoperfusion. The skin lesions of ScFN tend to improve spontaneously. However, ScFN may also lead to complications which cause serious problems. The severity of the etiologic factors contributing to the development of the disease determines the severity of complications. Therefore, these patients should be closely monitored for complications, especially for hypercalcemia which may be life-threatening. The severity and duration of hypercalcemia are associated with the extensity of skin lesions. We present a newborn who developed ScFN as a result of systemic hypotension. The ScFN resolved after the first few weeks of life, but the patient developed mild hypercalcemia during the 4-month follow-up period. The infant was breast-fed during follow-up, and vitamin D prophylaxis was not initiated. The hypercalcemia resolved within four months without any complications. We would like to draw attention to the need to monitor serum calcium levels in these infants and to refrain from initiating vitamin D prophylaxis in the first months of life.

Figure 1. Erythematous skin lesions, red-purple in color were located on the back, shoulders, the external surfaces of the arms, and on the anterior medial side of the thighs

Figure 2a. Focal nonspecific inflammation consisting of histiocytes and lymphocytes (a), eosinophilic crystals with radial extension in the necrotic fat cells (b)

Figure 1. Erythematous skin lesions, red-purple in color were located on the back, shoulders, the external surfaces of the arms, and on the anterior medial side of the thighs