Mahé E, Girszyn N, Hadj-Rabia S, Bodemer C, Hamel-Teillac D, De Prost Y
Department of Dermatology, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Br J Dermatol. 2007 Apr;156(4):709-15. doi: 10.1111/j.1365-2133.2007.07782.x.
Subcutaneous fat necrosis (SFN) of the newborn is a rare acute transient hypodermatitis that develops within the first weeks of life in term infants. It often follows a difficult delivery. Prognosis is generally good except for the development of hypercalcaemia in severe cases. Only several case reports or small patients series have been published.
To evaluate risk factors, complications and outcomes of SFN in 16 consecutive patients seen from 1996 to 2002 in our Department of Paediatric Dermatology.
On a case-report form created for the study, we recorded putative risk factors concerning the mother, pregnancy and delivery, clinical aspects of SFN, and early and late outcomes. The study was conducted in two stages: the first was a retrospective analysis of the observations and the second analysed data collected on children and their parents during a new consultation (n=10).
All the children were born at term. Lesions appeared a mean of 4 days after delivery. Three-quarters of the children had diffuse SFN. Risk factors identified were newborn failure to thrive (12/16), forceps delivery (7/16), maternal high blood pressure (3/10) and/or diabetes (2/10), and newborn cardiac surgery (1/16). Putative novel risk factors were macrosomia (7/16), exposure to active (4/10) or passive (3/10) smoking during pregnancy, putative or known maternal, paternal or newborn risk factors for thrombosis (5/10), and dyslipidaemia (2/10). Complications were hypercalcaemia (9/16), pain (4/16), dyslipidaemia (1/16), renal insufficiency (1/16) and late subcutaneous atrophy (6/6).
This study on 16 newborns with SFN provides new information. Familial or newborn risk factors for thrombosis are frequent. Macrosomia, familial dyslipidaemia and smoking should be evaluated. The main complications identified were severe pain, hypercalcaemia and subcutaneous atrophy.
新生儿皮下脂肪坏死（SFN）是一种罕见的急性短暂性皮下炎症，发生于足月儿出生后的头几周内。通常在难产之后出现。除严重病例发生高钙血症外，预后一般良好。仅有几例病例报告或小样本患者系列发表。
评估1996年至2002年期间在我们儿科皮肤科连续诊治的16例患者中SFN的危险因素、并发症及转归。
在为该研究设计的病例报告表上，我们记录了与母亲、妊娠及分娩相关的假定危险因素、SFN的临床情况以及早期和晚期转归。该研究分两个阶段进行：第一阶段是对观察结果进行回顾性分析，第二阶段分析在新的会诊期间（n = 10）收集的有关儿童及其父母的数据。
所有儿童均为足月儿。皮损平均在出生后4天出现。四分之三的儿童患有弥漫性SFN。确定的危险因素有新生儿生长发育不良（12/16）、产钳助产（7/16）、母亲高血压（3/10）和/或糖尿病（2/10）以及新生儿心脏手术（1/16）。假定的新危险因素有巨大儿（7/16）、孕期暴露于主动吸烟（4/10）或被动吸烟（3/10）、假定的或已知的母亲、父亲或新生儿血栓形成危险因素（5/10）以及血脂异常（2/10）。并发症有高钙血症（9/16）、疼痛（4/16）、血脂异常（1/16）、肾功能不全（1/16）以及晚期皮下萎缩（6/6）。
这项对16例患有SFN的新生儿的研究提供了新信息。血栓形成的家族性或新生儿危险因素很常见。应评估巨大儿、家族性血脂异常和吸烟情况。确定的主要并发症是严重疼痛、高钙血症和皮下萎缩。
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