Subcutaneous Fat Necrosis as a Complication of Whole-Body Cooling for Birth Asphyxia

Department of Pediatrics, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA.
Archives of dermatology (Impact Factor: 4.79). 08/2010; 146(8):882-5. DOI: 10.1001/archdermatol.2010.176
Source: PubMed


BACKGROUND: Subcutaneous fat necrosis (SCFN) of the newborn is a form of panniculitis that affects full-term neonates who often have suffered either birth asphyxia or hypothermia. The induction of hypothermia in newborns is becoming frequently used to reduce the neurologic sequelae associated with birth asphyxia. The risk of SCFN in neonates undergoing this therapy is unknown. Observation We describe a neonate who developed an abscess-like presentation of SCFN and subsequent asymptomatic hypercalcemia after undergoing whole-body cooling for hypoxic-ischemic encephalopathy. CONCLUSIONS: Hypothermia protocols may be placing newborns at increased risk for the development of SCFN. Clinicians should recognize this association, and newborns who undergo therapeutic cooling should have frequent dermatologic assessments.

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    • "To the best of our knowledge, SCFN has not been previously reported in association with passive cooling, while on the other hand a possible association with whole body cooling has been suggested [3] [4]. In our patient, passive cooling is in most likelihood not the sole cause responsible for the development of SCFN, although it may have accelerated the pathogenic process in the presence of other underlying risk factors. "
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    ABSTRACT: Subcutaneous fat necrosis (SCFN) is an inflammatory disorder of adipose tissue. The main risk factors for the development of SCFN are perinatal asphyxia and hypothermia. Presented here is a case of a newborn who developed SCFN in association with polycythemia and hypocalcemia following treatment by passive cooling. Neonates who undergo passive or whole body cooling therapy should be closely monitored for any signs of SCFN.
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