Subcutaneous Fat Necrosis in a Newborn after Brief Therapeutic Hypothermia: Ultrasonographic Examination

Abstract

A 7-day-old infant developed erythematous indurated plaques on the back, left shoulder, and arm a few days after therapeutic hypothermia. Ultrasonographic study along with Doppler blood flow analysis of lesional skin areas revealed flogistic fat involvement and calcifications. On the basis of clinical appearance, patient history, and ultrasonographic study, a diagnosis of subcutaneous fat necrosis of the newborn was established.

Fine‐Needle Aspiration as a Method of Diagnosis of Subcutaneous Fat Necrosis of the Newborn

“…Although SCFN is rare, the diagnosis is made mostly on clinical grounds (with or without skin biopsy) . Tognetti et al proposed that a skin biopsy can be avoided by performing an ultrasound of the lesion.…”

“…Subcutaneous fat necrosis (SCFN) of the newborn is a rare, transient panniculitis that develops in full‐term infants in the first few days to weeks of life . It begins as an area of edema that progresses to an indurated plaque or nodule with a purplish‐red color . These lesions range from single small nodules (<1 cm) to multiple large nodules up to 8 cm in diameter .…”

“…They are mostly firm but can become fluctuant and rupture, with subsequent drainage of a necrotic, yellow, chalk‐like fatty substance . Risk factors for development of SCFN include perinatal asphyxia, meconium aspiration, macrosomia, maternal diabetes, obstetric trauma, and therapeutic hypothermia (whole‐body or selective head cooling) . Diagnosis is usually made based on clinical presentation and often skin biopsy .…”

“…Risk factors for development of SCFN include perinatal asphyxia, meconium aspiration, macrosomia, maternal diabetes, obstetric trauma, and therapeutic hypothermia (whole‐body or selective head cooling) . Diagnosis is usually made based on clinical presentation and often skin biopsy . Fine‐needle aspiration biopsy (FNAB) is another, albeit less well‐recognized procedure that can allow for rapid diagnosis of SCFN .…”

“…Diagnosis is usually made based on clinical presentation and often skin biopsy . Fine‐needle aspiration biopsy (FNAB) is another, albeit less well‐recognized procedure that can allow for rapid diagnosis of SCFN .…”