What are the other Names for this Condition? (Also known as/Synonyms)

• SCFN (Subcutaneous Fat Necrosis of the Newborn)
• SFNN (Subcutaneous Fat Necrosis of the Newborn)

What is Subcutaneous Fat Necrosis of the Newborn? (Definition/Background Information)

• Subcutaneous Fat Necrosis of the Newborn (SCFN or SFNN) is a benign skin condition that occurs in infants within the first few weeks of life
• It is a form of panniculitis that indicates an inflammation of the fat (adipose) tissue. Subcutaneous Fat Necrosis of the Newborn results in the thickening of skin causing the formation of plaques and nodules
• The cause of Subcutaneous Fat Necrosis of the Newborn is unknown. The skin lesions from SCFN may be localized or generalized on the body. It can involve any part of the body skin
• Generally, no treatment is needed for children with Subcutaneous Fat Necrosis of the Newborn, since the condition is known to resolve spontaneously. In a vast majority, the prognosis of the condition is good
• In some individuals, Subcutaneous Fat Necrosis of the Newborn can result in complications, such as increased serum calcium or platelet levels, following resolution of the condition. Hence, regular follow-up with the healthcare provider is important and recommended

Who gets Subcutaneous Fat Necrosis of the Newborn? (Age and Sex Distribution)

• Subcutaneous Fat Necrosis of the Newborn is a rare condition that manifests in newborn children within the first few weeks (2-3 weeks) of life
• It may be seen in both male and female babies
• No racial or ethnic group predilection is observed

What are the Risk Factors for Subcutaneous Fat Necrosis of the Newborn? (Predisposing Factors)

The following risk factors have been associated with Subcutaneous Fat Necrosis of the Newborn:

• During pregnancy:
  • Severe gestational diabetes
  • Epilepsy in expectant mother
  • Chronic illegal drug use during pregnancy
  • Presence of uterine fibroids during pregnancy
  • Difficult pregnancy
• During delivery:
  • Injury during birth; use of forceps during birth of the baby
  • Long childbirth
  • Hypothermia of the fetus
  • Hypoxia of fetus
  • Meconium aspiration
  • Severe eclampsia
  • Preterm labor
  • Difficulty in birth caused by awkward fetal position
  • Severe peripartum bleeding

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Subcutaneous Fat Necrosis of the Newborn? (Etiology)

• The exact cause of Subcutaneous Fat Necrosis of the Newborn is currently unknown
• It occurs from the presence of fat necrosis within the subcutaneous tissue

What are the Signs and Symptoms of Subcutaneous Fat Necrosis of the Newborn?

The signs and symptoms of Subcutaneous Fat Necrosis of the Newborn may include:

• Presence of reddish plaques and nodules on skin; thickened skin at these sites
• These erythematous (red) nodules are seen on the cheeks, shoulders, upper arms, back, thighs, and buttocks
• The skin lesions may be focal to a region or widespread on the body
• The lesions may be tender to touch, but pain is generally not observed

How is Subcutaneous Fat Necrosis of the Newborn Diagnosed?

Subcutaneous Fat Necrosis of the Newborn may be diagnosed using the following tests and exams:

• Complete physical examination with comprehensive evaluation of medical history
• Blood tests:
  • To detect serum amylase and lipase levels
  • CBC with differentials may show low white cell count and decreased hemoglobin (anemia)
  • Blood electrolyte may reveal abnormal levels
  • Erythrocyte sedimentation rate (ESR) blood test may show increased ESR
  • C-reactive protein blood test may show increased C-reactive protein levels
  • Liver function test (LFT) may be abnormal 
• Blood and tissue culture for bacteria, fungal, and viral infections
• Urine tests to check for lipase and amylase levels
• Radiographic studies of the affected region such as X-rays, CT and MRI scans
• Tissue biopsy: A biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Subcutaneous Fat Necrosis of the Newborn?

The complications due to Subcutaneous Fat Necrosis of the Newborn may include:

• Sometimes, the nodules may ulcerate and bleed, resulting in the formation of scars on healing
• Bacterial and fungal infections: The condition may providing a suitable environment for bacteria and fungi to grow and thrive, resulting in secondary infections
• Emotional stress and psychological trauma to the parents
• In some cases, it can cause elevated calcium levels (hypercalcemia) in blood, about 1-4 months after the symptoms go away
• After resolution of the rash, it can result in decreased blood platelet levels (termed thrombocytopenia)

How is Subcutaneous Fat Necrosis of the Newborn Treated?

• Generally, no treatment is necessary for Subcutaneous Fat Necrosis of the Newborn. The condition usually resolves without treatment on its own
• Providing reassurance and helping with feelings of stress and anxiety (especially for the parents and care providers)
• Management of blood calcium levels through diet control and medications

Follow-up care with regular screening and checkups are important, after resolution of the condition.

How can Subcutaneous Fat Necrosis of the Newborn be Prevented?

Current medical research has not established a method of preventing Subcutaneous Fat Necrosis of the Newborn. However, the following factors may be considered to reduce the risk for the condition:

• Avoid the use of illegal drugs during pregnancy
• Undertake early and appropriate treatment for gestational diabetes, epilepsy, and uterine fibroids, prior to planning for pregnancy
• A careful and periodic monitoring of the pregnancy is advised and recommended

What is the Prognosis of Subcutaneous Fat Necrosis of the Newborn? (Outcomes/Resolutions)

• The prognosis of Subcutaneous Fat Necrosis of the Newborn is generally good, since it is a benign and self-limiting condition
• Following resolution of the condition, regular medical screening at periodic intervals with blood tests, scans, and physical examinations, are recommended

Additional and Relevant Useful Information for Subcutaneous Fat Necrosis of the Newborn:

There are many different types of panniculitis and it has been difficult to obtain an accurate picture of their true incidence, since they may be associated with so many conditions. The different types may include:

• Lupus panniculitis
• Pancreatitis-associated panniculitis
• Alpha-1 antitrypsin deficiency associated panniculitis
• Infective panniculitis