Liquefactive subcutaneous fat necrosis of the newborn

Subcutaneous fat necrosis of the newborn is a disease affecting neonates in the first weeks to months of life. It is characterized by dermal edema and underlying fat necrosis, typically presenting with firm, erythematous subcutaneous plaques and nodules, often located on the shoulders, back, buttocks, thighs, and extremities. We report an unusual presentation of liquefactive subcutaneous fat necrosis of the newborn in a two-week old term infant. The neonatal period was complicated by respiratory failure requiring intubation and severe encephalopathy. After completion of therapeutic hypothermia, the patient developed fluctuant and liquefactive nodules on her back. The neonate also had initial hypocalcemia that required treatment and then developed hypercalcemia, that resolved without intervention. The nodules and plaques on her back persisted into the first year of life and then gradually started to improve when she was 13 months old.