Sclerema neonatorum pathology

Author: Assoc Prof Patrick Emanuel, Dermatopathologist, Auckland, New Zealand. January 2015.

Sclerema neonatorum usually affects gravely ill, preterm neonates in the first week of life. It is characterised by hardening of the skin that gets bound down to the underlying structures.

Histology of sclerema neonatorum

In sclerema neonatorum, needle-shaped crystals are arranged radially in adipocytes. There is little or no associated inflammatory infiltrate and no fat necrosis (figures 1, 2).

Special studies for sclerema neonatorum

None are generally needed.

Differential diagnosis of sclerema neonatorum

Poststeroid panniculitis and subcutaneous fat necrosis of the newborn: These show identical crystals but there is associated inflammatory and foreign body response.

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