Subcutaneous Fat Necrosis in a Newborn: A Rare Benign Condition Mimicking Malpractice or Trauma

Background: Subcutaneous fat necrosis (SCFN) is a rare, self-limiting panniculitis, typically appearing in the initial months of life of full-term newborns as firm, red or purple subcutaneous nodules. While it often resolves spontaneously within a number of weeks, it may lead to serious complications.Case details: A newborn presented with progressive purplish, non-tender, firm subcutaneous nodules localized to the back, shoulders, buttocks, neck, arms, forearms, thighs. A detailed history and clinical examination were established. Laboratory investigations were done which were within normal limits. the patient was receiving supportive care and monitoring for metabolic complications.Conclusion: SCFN must be monitored for the potential development of hypoglycaemia, thrombocytopenia, hypertriglyceridemia, and, in particular, hypercalcemia.The exact etiology remains unclear, but it is strongly associated with perinatal stressors, such as birth asphyxia, hypoxia, hypothermia, cord accidents, meconium aspiration, obstetric trauma, and maternal conditions like preeclampsia, diabetes, cocaine or cigarette exposure, and antihypertensive calcium medications during pregnancyDiagnosis is mainly clinical but may be supported by ultrasound or biopsy. Management includes supportive care and monitoring for metabolic complications.In conclusion, a newborn presenting with skin lesions indicative of SCFN must be monitored for the potential development of hypoglycaemia, thrombocytopenia, hypertriglyceridemia, and, in particular, hypercalcemia.