Subcutaneous fat tissue necrosis of the newborn P83.80

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Adiponecrosis subcutanea neonatorum; Adiposclerosis symmetrical; fat tissue necrosis, subcutaneous of the newborn; subcutaneous fat necrosis of the newborn; Subcutaneous fat necrosis of the newborn; Symmetrical fatty sclerosis

History
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Cause 1875

Definition
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2-3 days after birth, often symmetrical fatty sclerosis.

Etiopathogenesis
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Heterogeneous. Consequence of traumatisation of the subcutaneous fatty tissue at birth, perinatal asphyxia or meconium aspiration.

Localization
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Mainly shoulder and buttock region, cheeks, proximal extremities.

Clinical features
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Brownish or blue-red, coarse, well defined, deep-seated, hardly shiftable, large, pressure indolent nodules or plate-like hardenings which appear 1-3 weeks after birth of the otherwise healthy infants. After initial manifestation often increasing for several weeks or months, then spontaneously involuting.

Histology
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Lobular panniculitis with fatty tissue necrosis. Mostly alternating dense infiltrates of clustered foam cells and multinucleated giant cells with radial "needle shaped clefts". Fibroblasts in varying numbers. The needle-like, optically empty spaces correspond to dissolved fatty acid crystals. Rare occurrence of calcifications.

Diagnosis
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Clinic, histology, regular calcium checks

Differential diagnosis
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Sclerema adiposum neonatorum (poor prognosis, rapid progressive course; histological difference: no significant inflammatory features).

Complication(s)
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Often hypercalcemia. Rarely septic softening.

Therapy
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Symptomatic; if necessary, rehydration, baths, heat, cotton wool bandages, avoidance of further mechanical stress.

Progression/forecast
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Recovery after several weeks to months without significant residual lipatrophies.

Literature
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  1. Bachrach LK (1999) Etidronate in subcutaneous fat necrosis of the newborn. J Pediatr 135: 530-531
  2. Burden AD et al (1999) Subcutaneous fat necrosis of the newborn: a review of 11 cases. Pediatric Dermatol 16: 384-387
  3. Norton AI (1997) Subcutaneous fat necrosis of the newborn: CT findings of head and neck involvement. At J Neuroradiol 18: 547-550
  4. Repiso-Jimenez JB (1999) Subcutaneous fat necrosis of the newborn. J Eur Acad Dermatol Venereol 12: 254-257
  5. Tran JT et al (2003) Complications of subcutaneous fat necrosis of the newborn: a case report and review of the literature. Pediatric Dermatol 20: 257-261
  6. Varan B (1999) Subcutaneous fat necrosis of the newborn associated with anemia. Pediatric Dermatol 16: 381-383

Outgoing links (1)

Sclerema adiposum neonatorum;

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020