Section : Skin Conditions Section : Conference Notes

Subcutaneous Fat Necrosis of the Newborn

Subcutaneous Fat necrosis of the newborn

What is Subcutaneous Fat necrosis of the newborn ?

  • It is a lobular panniculitis.
  • It is associated with complications during labor (labour)
  • It presents as asymptomatic indurated subcutaneous dark-red nodules which are typically located in bone proeminant areas (upper back, proximal limbs, cheeks…)

When does it occur ?

  • It occurs between 1 and 5 weeks following delivery.

Why does it happen ?

It is largely unknown but here is a hypothesis:

  • Fat in the newborn contains a higher proportion of saturated fat; more exactly palmitate (palimitic acid). Saturated fat has a lower melting point (solid to liquid transition), which means that it crystallizes more easily.
  • Because of fetal suffering (which consists of meconium aspiration, preeclampsia, prolonged labor, caesarean section…)…there is injury to the subcutaneous fat tissue which then crystallizes.

How does it evolve ?

  • It resolves itself spontaneously within one to 4 months.
  • There is no scar.
  • Complications are of hypercalcemia which can lead to cardiac, neurological, and/or nephrologic impairement.

What is the differential diagnosis ?

  • Diagnosis is usually straightforward but Sclerema Neonatorium must be differentiated. It is a diffuse subcutaneous sclerosis which heals with fibrosis.
  • It is considered by some as an extensive form of subcutaneous fat necrosis.

One word on the classification of panniculitis

  • Panniculitis is classified into septal, lobular or mixed forms.
  • Although not exhaustive here, causes of lobular panniculitis include, lupus panniculitis, infectious panniculitis, erythema induratum of Bazin. Septal causes include erythema nodosum.

Comment: In the French literature, it is entrenched in the mind of some dermatologists that “panniculite” is used for lobular panniculitis.

Source of Information:

Laffitte E. 2012 (09) – 21st Annual Congress of the EADV (European Academy of Dermatology and Venerology) – Prague (Praha), Czech Republic (česká republika)

Dubertret L. Thérapeutique Dermatologique, 2011 Online Edition

Category : Cytostéatonécrose du Nouveau-Né - Modifie le 09.29.2012Category : Subcutaneous Fat Necrosis of the Newborn - Modifie le 09.29.2012