Subcutaneous Adipose Derangements of the Newborn

Marks, Meyer B.

doi:10.1001/archpedi.1962.02080030124004

Cited by 5 publications

(7 citation statements)

References 21 publications

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“…Needle-shaped crystals are not only seen mainly in multinucleate giant cells but also in lipocytes. 2,8,16,17,24 These crystals are larger than those seen in SN and are arranged in rosettes. They are not diagnostic of SCFN as they have been found as post-mortem breakdown products and in lesions of BCG vaccination.…”

Section: Managementmentioning

confidence: 93%

“…Arguments that go against the view of trauma as an etiology of SCFN are that it has occurred in deliveries with no or minimal trauma. 24 Silverman 30 support the theory that an underlying biochemical defect in composition and metabolism of fat predisposes to this condition, whereas Elliott 8 support the view that it is not true fat necrosis but adipose cell necrosis due to trauma and local anoxemia. The histopathological findings show necrosis of subcutaneous adipocytes.…”

Section: Managementmentioning

confidence: 97%

“…These lesions remain circumscribed, do not spread, disappear spontaneously over a period of months or turn cystic or calcify. [22][23][24] Asphyxia, mechanical and thermal trauma have been postulated in the pathogenesis of SCFN. Arguments that go against the view of trauma as an etiology of SCFN are that it has occurred in deliveries with no or minimal trauma.…”

Section: Managementmentioning

confidence: 99%

“…Body temperature is usually subnormal and the infant is apathetic. 4,24,31,32 Histopathology shows lobular panniculitis without vasculitis with an inflammatory infiltrate of lymphocytes and histiocytes in the fat lobules. There is marked edema in skin, subcutaneous tissue and sometimes underlying muscle.…”

Section: Managementmentioning

confidence: 99%

“…There is marked edema in skin, subcutaneous tissue and sometimes underlying muscle. 2,24,32 This condition differs from scleredema adultorum, also known as scleredema adultorum of Buschke or acute sclerosis, which is a connective tissue disorder presenting in adults with brawny, hard, nonpitting skin that cannot be moved freely over underlying tissue, but can be compressed between thumb and finger to produce superficial ridges. It occurs in three types and is characterized by deposition of mucopolysaccharides in and around the collagen fibers in the dermis.…”

Section: Managementmentioning

confidence: 99%

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Sclerema neonatorum: a review of nomenclature, clinical presentation, histological features, differential diagnoses and management

Zeb

Darmstadt

2008

J Perinatol

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Objective: To review published literature on sclerema neonatorum (SN) in order to clarify its clinical presentation, histological features and management compared with two other diseases: subcutaneous fat necrosis of the newborn (SCFN) and scleredema.Study Design: PubMed database was searched using the key words Sclerema neonatorum. A total of 55 articles from peer-reviewed journals were reviewed and summarized.Result: SN, SCFN and scleredema are diseases of the subcutaneous adipose tissue. SN is characterized by hardening of the skin that gets bound down to the underlying muscle and bone, hindering respiration and feeding and is associated with congenital anomalies, cyanosis, respiratory illnesses and sepsis. Histology of the skin biopsy shows thickening of the trabeculae supporting the subcutaneous adipose tissue and a sparse inflammatory infiltrate of lymphocytes, histiocytes and multinucleate giant cells. SCFN has circumscribed hardening of skin on bony prominences with necrosis of adipocytes in subcutaneous tissue and a dense granulomatous infiltrate on histology. Scleredema is characterized by hardening of the skin along with edema; histology shows inflammatory infiltrate and edema in skin and subcutaneous tissues. SN has a high case fatality rate whereas SCFN and scleredema are self-limiting and lesions resolve within a few weeks to months. Exchange transfusion may improve survival in SN. Conclusion:The histological features of skin biopsy should be used to establish diagnosis of SN, SCFN and scleredema as disease-specific treatment is imperative in SN due to high fatality.

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Section: Managementmentioning

confidence: 93%

Section: Managementmentioning

confidence: 97%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

See 3 more Smart Citations

Sclerema neonatorum: a review of nomenclature, clinical presentation, histological features, differential diagnoses and management

Zeb

Darmstadt

2008

J Perinatol

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Red Nodules in an Infant

Liu¹

1986

Arch Dermatol

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Figure 1.Figure 2. REPORT OF A CASEA female infant was delivered by cesarean section at 41 weeks' gestation because of failure to induce labor. She was normal until 18 days of age, when her aunt, while bathing the baby, noted numerous "bumps" under the patient's skin. These lesions were shown to her pediatrician, who found no other abnormalities. There was concern about possible malignancy, and so the patient was transferred to North Carolina Memorial Hospital, Chapel Hill, for evaluation.On admission, several 0.5-to 1.0-cm erythematous to violaceous, slightly raised, freely movable, firm Figure 3.nodules were found on the upper back, anterior aspect of the chest, and left axilla (Figs 1 and 2). The lesions were not warmer than the rest of the skin, did not feel cystic, and did not appear to be tender. Results of laboratory evaluations, including cultures, complete blood cell count, and electrolyte level, were negative or normal. Her serum calcium level was 9.5 mg/dL (2.37 mmol/L) (normal, 7 to 12 mg/dL [1.75 to 2.99 mmol/L]).A biopsy specimen from the left axillary lesion was obtained (Figs 3 and 4).What is your diagnosis? Figure 4.Clinicians, local and regional societies, and residents andfellows in dermatology are invited to submit quiz cases to this section. Cases should follow the established pattern and be submitted double-spaced and in triplicate. Photomicrographs and illustrations must be clear and submitted as positive color transparencies (35 mm). Do not submit color prints unless accompanied by original transparencies. If photomicrographs are not available, the actual slide from the specimen will be acceptable.

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Studies on subcutaneous fat necrosis of the newborn

Pasyk¹

1978

Virchows Arch. A Path. Anat. and Histol.

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Biopsy specimens from the skin and subcutaneous fat tissue of four cases with neonatal subcutaneous fat necrosis were made and investigated by light and electron microscopy at 2, 4, and 6 weeks, and 5 months (Case 2) from the onset of the disease. Three stages of ultrastructural change of fat cells were observed. The evolution of crystal formation in the fat cells was seen and phagocytosis of crystals and fat droplets by macrophages and foreign-body giant cells was also noted. In the light microscope accumulation of calcium concretions in the spaces between and inside the fat cells was found. In the electron microscope we detected foci of highly electron-dense granules, which were similar in distribution and structure to calcium salts stained with the von Kossa method. Changes in small and medium size blood vessels were observed.

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Subcutaneous Adipose Derangements of the Newborn

Cited by 5 publications

References 21 publications

Sclerema neonatorum: a review of nomenclature, clinical presentation, histological features, differential diagnoses and management

Sclerema neonatorum: a review of nomenclature, clinical presentation, histological features, differential diagnoses and management

Red Nodules in an Infant

Studies on subcutaneous fat necrosis of the newborn

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