Subcutaneous fat necrosis of the newborn: light, ultrastructural and histochemical microscopic studies

Friedman, Stephen J.; Winkelmann, R. K.

doi:10.1111/j.1600-0560.1989.tb00018.x

Cited by 37 publications

(6 citation statements)

References 19 publications

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“…Although this hypothesis has been invoked to explain the SCFN occurring in neonates and infants undergoing hypothermic cardiac surgery, provocative testing with ice cube application to the skin of predisposed neonates failed to reproduce the SCFN. Some infants with SCFN progress and develop hypercalcemia (1)(2)(3)(4)(5)(6)(7)(8)(10)(11)(12)(13)(17)(18)(19). The hypercalcemic phase usually occurs during resolution of panniculitis but may occur concurrently.…”

Section: Discussionmentioning

confidence: 99%

“…It may appear over the trunk, arms, buttocks, and cheeks of full-term infants in the first one to two months of life. In some patients associated thrombocytopenia, hypoglycemia (1,2), hypercalcemia (2,3,(4)(5)(6)(7)(8), and hyperlipidemia (9) were reported. The hypercalcemia in particular is associated with a less favorable prognosis (3 deaths in a series of 15 patients) (10).…”

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confidence: 99%

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Subcutaneous Fat Necrosis, Hypercalcemia, and Prostaglandin E

Sharata

Postellon

Hashimoto

1995

Pediatric Dermatology

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We present two patients with subcutaneous fat necroses (SCFN) in whom endocrinologic studies revealed an association with elevated prostaglandin E (PGE) levels. A boy born after prolonged labor complicated by meconium aspiration developed erythematous, indurated plaques over the back, arms, buttocks, and cheeks at 4 days of age. A biopsy specimen of involved skin showed panniculitis with foci of necrotic adipocytes containing radially arranged, needle-shaped clefts and a granulomatous infiltrate in the septae. Laboratory studies revealed hypercalcemia of 13.6 mg/dl (normal 8.8-10.1 mg/dl), elevated 1.25-1.25(OH)2D3, and increased urinary excretion of PGE2. The child was hospitalized and treated with systemic steroids and diuretics, with resolution of SCFN and hypercalcemia. The second patient was a girl born with cyanotic heart disease. A diagnosis of Ebstein anomaly was made, and intravenous PGE1 was started to keep patent the ductus arteriosus. Four days later erythematous, indurated plaques were noted on the knee, back, and anterior chest. A skin biopsy specimen revealed SCFN. There was no associated laboratory abnormality. On discontinuing PGE1, no new lesions formed and the existing panniculitis resolved. These two cases demonstrate the association between SCFN and elevated PGE levels (endogenous in patient 1, exogenous in patient 2). No previous reports of SCFN after the administration of PGE1 have appeared in the literature.

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Section: Discussionmentioning

confidence: 99%

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Subcutaneous Fat Necrosis, Hypercalcemia, and Prostaglandin E

Sharata

Postellon

Hashimoto

1995

Pediatric Dermatology

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“…The clinical manifestations usually appear between the 1st and 4th week of life [11, 12, 13, 14, 15]. To date, very few cases with lesions present at birth have been reported [16, 17, 18, 19, 20].…”

Section: Commentmentioning

confidence: 99%

“…and the location of the lesions on pressure areas, where blood flow is impaired [21]. The histology of SFN reveals a lobular, granulomatous panniculitis with histiocytes and adipocytes containing needle-shaped, radially arranged clefts [14, 16]. The exact chemical nature of the fat crystals is controversial [16].…”

Section: Commentmentioning

confidence: 99%

Congenital Ulcerated Subcutaneous Fat Necrosis of the Newborn

1998

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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.

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“…[1][2][3][4][5][6] Histologically, these lesions characteristically show granulomatous inflammation of adipose tissue with prominent acicular crystalline clefts within adipocytes and multinucleate giant cells. ' In the appropriate clinical setting, nodules of SFNN can often be diagnosed without biopsy.…”

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confidence: 99%

Fine‐needle aspiration biopsy of subcutaneous fat necrosis of the newborn

Walker¹,

Smith²,

Cohen³

1993

Diagnostic Cytopathology

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This report provides the first description of the fine-needle aspiration biopsy findings in a case of subcutaneous fat necrosis of the newborn. While initial interpretation of the aspirate smears was suspicious for a neoplastic process, subsequent incisional biopsy confirmed the benign nature of the lesion. Review of the cytologic material revealed rare, negatively stained, needle-shaped crystals within histiocytes and multinucleate giant cells. In the appropriate clinical setting, and given a mixture of lymphocytes, histiocytes, and multinucleate giant cells in the aspirate smears, we believe the finding of negatively stained needle-shaped crystals can strongly suggest the diagnosis of subcutaneous fat necrosis of the newborn.

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Subcutaneous fat necrosis of the newborn: light, ultrastructural and histochemical microscopic studies

Cited by 37 publications

References 19 publications

Subcutaneous Fat Necrosis, Hypercalcemia, and Prostaglandin E

Subcutaneous Fat Necrosis, Hypercalcemia, and Prostaglandin E

Congenital Ulcerated Subcutaneous Fat Necrosis of the Newborn

Fine‐needle aspiration biopsy of subcutaneous fat necrosis of the newborn

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