Early Recognition of Subcutaneous Fat Necrosis of the Newborn With Atypical Purpuric Presentation

Subcutaneous fat necrosis of the newborn (SCFN) is a rare panniculitis that typically presents within the first few weeks of life. We report a unique case of SCFN diagnosed as early as day three of life in a large-for-gestational-age neonate born to a diabetic mother. Notably, the lesion exhibited a central purpuric area with an irregular, serrated erythematous border, which was clearly visualized using dermoscopy. Histological confirmation was limited due to sampling constraints, but the clinical features and evolution were consistent with SCFN. This case highlights the utility of early dermatologic assessment and dermoscopy in identifying SCFN with atypical hemorrhagic features, expanding the clinical spectrum of this condition.