Subcutaneous fat necrosis in a newborn following icebag application for treatment of supraventricular tachycardia

Abstract

Cases of subcutaneous fat necrosis of the newborn (SCFN) and neonatal cold panniculitis have been reported most often secondary to perinatal distress or hypothermia. We present a case of a newborn infant who developed erythematous, indurated plaques on both cheeks and right shoulder following ice pack application for supraventricular tachycardia. The distinction between SCFN and cold panniculitis is important as SCFN may have complications such as hypercalcemia, whereas cold panniculitis is not associated with such sequelae. Clinicians should be aware of the diagnostic similarities and differences between these two conditions because of differences in potential serious sequelae.

Subcutaneous Fat Necrosis and Hypercalcemia Following Therapeutic Hypothermia – a Patient Report and Review of the Literature

“…The disorder, initially described by Harrison and McNee in 1926, typically affects full term newborns, most often secondary to perinatal stress such as asphyxia, meconium aspiration syndrome or hypothermia [1][2][3][4] . Maternal risk factors such as gestational diabetes, smoking and preeclampsia have also been described 5 .…”

Strategies for reducing the incidence of skin complications in newborns treated with whole-body hypothermia

“…SFN has been described in newborns following hypothermia when abandoned on the street [21] or exposed to cold weather [22]. Moreover, cases of SFN have been observed in newborns treated with applications of ice bags for supraventricular tachycardia [23][24][25][26], or subjected to wholebody cooling before being placed on cardiopulmonary bypass for cardiovascular surgery [27][28][29][30]. Neonates have an increased risk of developing SFN due to the different composition of fatty acid concentrations.…”

“…This means that this study can only provide suggestions and recommendations for broader studies. Second, the patients studied had clinical features consistent with SFN, but they did not undergo biopsies or histological examinations necessary for differential diagnosis of cold panniculitis [23]. In fact, although both diseases may be clinically indistinguishable [24], their histopathologic findings are different [20].…”

Subcutaneous fat necrosis in newborn: case report

“…In most cases, lesions are spontaneously self-limiting in 2 to 4 weeks with no atrophy or residual scar. 2 Although the etiology of this disorder is unknown, the causes could be attributed to perinatal hypoxia, 3,4 aspiration of meconial amniotic fluid, hypothermia, 4 local trauma 3,5 and anemia. 6 The maternal risk factors that contribute to the development of SCFN include gestational diabetes, gestational hypertension, exposure of cocaine or calcium channel, use of blockers during pregnancy, and cigarettesmoking.…”