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2.1
Subcutaneous Fat Necrosis
Necrosis Subcutaneous Fat

Presentation

It usually presents in neonates who have experienced perinatal difficulty such as asphyxia, peripheral hypoxemia, hypothermia, meconium aspiration or trauma. [ncbi.nlm.nih.gov]

Entire Body System

  • Weight Loss

    If mild hypercalcaemia is present, symptoms may be absent, or the child may display irritability, weight loss, apathy, or hypotonia. Another known complication of SCFN is thrombocytopenia. [fn.bmj.com]

Gastrointestinal

  • Failure to Thrive

    Risk factors identified were newborn failure to thrive (12/16), forceps delivery (7/16), maternal high blood pressure (3/10) and/or diabetes (2/10), and newborn cardiac surgery (1/16). [ncbi.nlm.nih.gov]

    A 6-week-old female infant was admitted to our department due to failure to thrive, irritability and vomiting. [paedcro.com]

    Other symptoms of hypercalcemia are usually non-specific and consist of fever, vomiting, lethargy, constipation, feeding difficulties, and failure to thrive. [clinicalgate.com]

    Nephrocalcinosis without evidence of adverse renal outcomes has been reported to persist up to 4 years after follow-up. [25] Rarely, significant morbidity (seizures, blindness, failure to thrive) and even mortality (from infection and cardiac arrest) [emedicine.com]

Skin

  • Skin Disease

    This is consistent with previous observations of extrarenal 1alpha-hydroxylase in skin from other granulomatous conditions such as sarcoidosis and slack skin disease. [ncbi.nlm.nih.gov]

    Related Treatment of Skin Disease Comprehensive Therapeutic Strategies 4e [clinicalgate.com]

    National Women's Health, ADHB, Neonatal website Subcutaneous Fat Necrosis of the Newborn –Medscape Reference Books about skin diseases See the DermNet NZ bookstore . [dermnetnz.org]

    Infection Pancreatic disease Skin disease Diseases of the osteoarticular system Adipose tissue disorders Keyword (es) Agudo Bacteriosis Complicación Estudio caso Hombre Necrosis Osteítis Pancreatitis Paniculitis Subcutáneo Aparato digestivo patología [pascal-francis.inist.fr]

    St Louis Missouri: Mosby. 8-Ackerman AB.(1997).Histologic Diagnosis of Inflammatory Skin Diseases.2ed.Baltimore, Maryland. Williams and Welkins. 9-Jordaan HF, Van Niekerk DJ, Louw M.(1994). Papulonecrotic tuberculid. [conganat.org]

  • Subcutaneous Mass

    A physical examination revealed a well-mobile, large, soft subcutaneous mass in the right side of his back ( Figure 1 ). [omicsonline.org]

Neurologic

  • Lethargy

    Although most cases of SCFN resolve spontaneously, SCFN may be associated with symptomatic hypercalcemia presenting as lethargy, hypotonia, irritability, vomiting, polyuria, polydipsia, constipation, and dehydration. [ijpd.in]

    Other symptoms of hypercalcemia are usually non-specific and consist of fever, vomiting, lethargy, constipation, feeding difficulties, and failure to thrive. [clinicalgate.com]

    Hypocalcaemia and rarely hypercalcaemia are considered as major causes of morbidity and mortality in cases of SCFN. 1-4 Hypercalcaemia could be presented with lethargy, hypotonia, polyuria, polydipsia, dehydration, constipation, FTT and even sudden death [pjms.com.pk]

    The clinical manifestations are hypothermia associated with lethargy and generalized pitting edema of the skin simulating sclerema neonatorum. Etiology Exposure to cold. Intrauterine growth retardation, which results in a relatively thin panniculus. [drmhijazy.com]

  • Apathy

    If mild hypercalcaemia is present, symptoms may be absent, or the child may display irritability, weight loss, apathy, or hypotonia. Another known complication of SCFN is thrombocytopenia. [fn.bmj.com]

Workup

Our case highlights the importance of remaining vigilant in the workup of atypical rashes of the infant, which should include early assessment of serum electrolytes. [ncbi.nlm.nih.gov]

Treatment

We herein present a case of a newborn who developed subcutaneous fat necrosis-related hypercalcemia after hypothermia treatment for hypoxic ischemic encephalopathy. [ncbi.nlm.nih.gov]

Prognosis

The prognosis of the disease is generally good, but it may be complicated by potentially life-threatening metabolic alterations, including hypercalcemia, thrombocytopenia, hypoglycemia, and hypertriglyceridemia. [ncbi.nlm.nih.gov]

Etiology

Extensive evaluation for the electrolyte disturbances revealed no other etiology. This case reinforces that SCFN should be considered in newborns with hypercalcemia of unknown etiology. [ncbi.nlm.nih.gov]

Clinical Features: Indurated erythematous or violaceous nodules of unknown etiology appearing in the first few weeks of life Affects full-term or post-term infants. [dermpedia.org]

Etiology Different predisposing factors play an important role in the etiology of subcutaneous fat necrosis of the newborn. [drmhijazy.com]

We need to emphasize greater awareness of the possibility of abuse in children who present for medical care when the etiology is obscure. [annsaudimed.net]

Epidemiology

Epidemiology [ 1 ] Lipomas may be seen in all age groups, but usually first appear between 40 and 60 years of age. Solitary lipomas are more common in women. Multiples - referred to as lipomatosis - are more common in men. [patient.info]

We can't do much more," Carlo La Vecchia, head of epidemiology at the University of Milan, said in an interview. "It's time to move on to other things." La Vecchia spoke Thursday at a European breast cancer conference in Barcelona. [feliciaenache.blogspot.com]

[…] maternal hypercoagulable state such as protein C deficiency and antiphospholipid syndrome. [23] Local pressure trauma during delivery from forceps, from prolonged labor, and from being large for gestational age (macrosomia) may play a role. [20, 21] Epidemiology [emedicine.com]

References Richardson T Kerr D 2003 Skin-related complications of insulin therapy, epidemiology and emerging management strategies. [edmcasereports.com]

Pathophysiology

Pathophysiology may include enhanced gastrointestinal calcium absorption and bone resorption. We treated an infant with SFN and serum calcium of 15 mg/dL with prednisolone and low‐dose zoledronic acid. [ingentaconnect.com]

DISCUSSION SCFN is a rare, often painful condition of unknown pathophysiology. [fn.bmj.com]

The pathophysiology of hypercalcaemia is not known completely but calcium release from necrotic fat cells and production of 1, 25 (OH) 2 vit D from granulomatous cells (like macrophages) result to prostaglandin production which increases osteoclatsic [pjms.com.pk]

Subcutaneous fat necrosis of the newborn usually runs a self-limited course, but it may be complicated by hypercalcemia and other metabolic abnormalities. [1, 2] Pathophysiology The exact pathogenesis of subcutaneous fat necrosis of the newborn (SFNN) [emedicine.com]

Prevention

Although patients need long-term follow-up to prevent hypercalcemia, the prognosis is generally favorable. [ncbi.nlm.nih.gov]

The early diagnosis and prompt treatment of hypercalcemia are essential to prevent severe complications. Keywords: Hypercalcemia; Fat Necrosis; Infant, Newborn; Nephrocalcinosis; Subcutaneous Fat. Refbacks There are currently no refbacks. [actamedicaportuguesa.com]

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