Congenital Ulcerated Subcutaneous Fat Necrosis of the Newborn

Abstract

A neonate, born from a mother with hypertension during the last trimester of gestation, presented with ulcerated lesions on the right lower limb that had been present since birth. The baby also had necrosis of the fifth toe of the right foot and generalized muscle hypoplasia of the entire limb. The histologic appearance of the cutaneous lesions was diagnostic of subcutaneous fat necrosis of the newborn. The congenital presence of subcutaneous fat necrosis is exceptional, and to date, ulcerated forms have not been reported in the literature.

Congenital Ulcer of the Buttock

“…Histopathologic examination in CVIC shows coagulative necrosis of the dermis, subcutaneous tissue, or even deeper structures . A case of congenital ulcerated subcutaneous fat necrosis of the newborn affecting the lower leg and foot has been published , but the appearance of the ulcerated area is similar to CVIC . In our patient, the small size of the ulcer, its location on the buttock, and the absence of any compartment syndrome are inconsistent with a diagnosis of CVIC, although the appearance of our patient's ulcer did not coincide with skin disorders such as aplasia cutis congenita, Bart syndrome, and amniotic bands; such defects are usually linear or bandlike and favor locations other than the buttock.…”

Neonatal Forearm Compartment Syndrome

“…[2,6,7] Despite the requirement of early diagnosis and prompt intervention, the treatment option, whether surgical or medical, may vary. Therefore, a detailed work up with a team of plastic surgeons, neonatalogists and dermatologists is mandatory for the definitive diagnosis.…”

Congenital Volkmann ischaemic contracture: a case report and review

“…Subcutaneous fat necrosis of the newborn has a usual presentation of red to bluish plaques or firm, mobile nodules over bony prominences, including arms, cheeks, shoulders and buttocks 23,24 that is easily distinguished from CVIC. However, a report of congenital ulcerated subcutaneous fat necrosis poses a potential diagnostic challenge because it demonstrated an extensive unilateral necrosis and hypoplasia of the lower extremity 25 . The ulcerated subcutaneous fat necrosis lacked the muscle contracture and nerve palsy typical of CVIC.…”

“…However, a report of congenital ulcerated subcutaneous fat necrosis poses a potential diagnostic challenge because it demonstrated an extensive unilateral necrosis and hypoplasia of the lower extremity. 25 The ulcerated subcutaneous fat necrosis lacked the muscle contracture and nerve palsy typical of CVIC. Like most cases of subcutaneous fat necrosis, that patient's biopsy demonstrated adipocytes with radially arranged needle-shaped clefts and panniculitis which were absent in our biopsy.…”