Subcutaneous fat necrosis (SCFN) usually occurs in the first few weeks of life as a result of ischemia to the adipose tissue, often adjacent to a bony structure, following a traumatic delivery or in a baby who is undergoing cooling therapy for HIE. SCFN is characterized by firm, indurated nodules and plaques on the back, buttocks, thighs, forearms and cheeks. The nodules and plaques may be erythematous, flesh colored or blue.
Fortunately, SCFN is not so commonly seen and is generally self-limiting, with resolution usually occurring by six to eight weeks of age. These infants require long-term follow-up for the development of hypercalcemia, which can occur up to six months after the initial presentation of the skin lesions
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