Subcutaneous Fat Necrosis in a Term Male Neonate with Perinatal Asphyxia : A Case Report

Subcutaneous fat necrosis (SCFN) is an uncommon and yet, a benign condition seen in full term neonates who experience perinatal asphyxia and or traumatic delivery. It is temporary, self limited condition of unknown pathophysiology. Characteristic lesions are indurated, erythematous nodules or plaques over the areas prone for pressure such as back, arms, buttocks, thighs and face. This condition is known to be associated with maternal disorders such as diabetes, pre-eclampsia and maternal substance abuse which leads to fetal hypoxia. Also, it is seen in perinatal complications like perinatal asphyxia, meconium aspiration syndrome, hypothermia, hypoxemia and hypoglycemia. The associated complications are anemia, thrombocytopenia, hypo or hypercalcemia. While the cutaneous lesions of SCFN are self limiting, the hypercalcemia might have a fatal outcome if unnoticed and untreated. Hereby we are reporting a 29 days old, term, male neonate with subcutaneous fat necrosis. A 29 days old male neonate was admitted with multiple, painful, erythematous and tender nodular lesions over the back and shoulders from tenth day of life. The neonate was born to a primi-gravida at term gestation by vaginal delivery, with birth weight of 2700gms. There was a history of prolonged labour and the neonate had perinatal asphyxia, no other maternal risk factors could be elicited. There was no history of birth trauma or other perinatal morbidities. However the infant had hypothermia. Investigations revealed positive sepsis screen, normocalcemia with anemia. Skin biopsy was consistent with SCFN. Infant received supportive care and the lesions regressed in follow up over a period of three months. In conclusion, we report a rare case of Subcutaneous fat necrosis in a term male neonate with perinatal asphyxia, hypothermia with normocalcemia and anemia.