Subcutaneous fat necrosis of the newborn complicated by severe hypercalcemia and hypertriglyceridemia

Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by firm, indurated plaques and subcutaneous nodules with purplish-red color, typically occuring between the 1st and 6th weeks of life. While generally benign and self-resolving, this condition can occasionally lead to severe complications. We report the case of a female newborn with a maternal history of hypothyroidism and severe preeclampsia, and a personal history of perinatal asphyxia and sepsis, admitted on the 20th day of life for fever and dehydration. Dermatological examination revealed indurated purplish-red nodules on the back and arms. Laboratory tests showed severe hypercalcemia and hypertriglyceridemia, while renal ultrasound revealed nephrocalcinosis. A diagnosis of SCFN, complicated by severe hypercalcemia, hypertriglyceridemia and nephrocalcinosis, was made. The patient was treated with intravenous fluids, diuretics, and corticosteroids, resulting in clinical and biological improvement. Although SCFN often resolves spontaneously, severe complications like hypercalcemia may require intervention. Early diagnosis and management, particularly in neonates with multiple risk factors, are crucial to prevent complications. Further research is needed to optimize treatment strategies and improve outcomes for affected infants.