Background: Subcutaneous fat necrosis (SCFN) of the newborn is a rare condition that manifests within days after birth. The interscapular region, axillae and shoulders are the most commonly affected sites, corresponding to anatomic sites of brown adipose tissue (BAT) in newborns. Objective: We postulated a specific involvement of BAT in SCFN and searched for brown adipocytes at affected sites. Methods: Biopsy specimens were immunostained with antibodies against uncoupling protein 1 (UCP-1) and examined by electron microscopy. We also examined BAT by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography and computed tomography (PET-CT) scanning. Results: A few cells in biopsy specimens from two patients bound antibodies against UCP-1, and brown adipocytes were detected at several stages of degeneration. PET-CT scans revealed lower uptake of 18F-FDG at major sites of SCFN. Conclusion: SCFN and BAT can be found at the same sites, suggesting a pathophysiological connection.

Keywords:
Subcutaneous fat necrosis of the newborn, Brown adipose tissue, Asphyxia, Hypoxemia
1.
Chen TH, Shewmake SW, Hansen DD, Lacey HL: Subcutaneous fat necrosis of the newborn. Arch Dermatol 1981;117:36–37.
2.
Mahe E, Girszyn N, Hadj-Rabia S, et al: Subcutaneous fat necrosis of the newborn: a systematic evaluation of risk factors, clinical manifestations, complications and outcome of 16 children. Br J Dermatol 2007;156:709–715.
3.
Silverman AK, Michels EH, Rasmusssen JE, Arbor A: Subcutaneous fat necrosis in an infant, occurring after hypothermic cardiac surgery. Case report and analysis of etiologic factors. J Am Acad Dermatol 1986;15:331–336.
4.
Ivy RE, Howard FH, Orleans N: Subcutaneous fat necrosis of the newborn infant. Report of a case in an infant born by cesarean section and with no anoxia. J Pediatr 1953;42:600–602.
5.
Heaton JM: The distribution of brown adipose tissue in the human. J Anat 1972;112:35–39.
6.
Flory CM: Fat necrosis of the newborn. Report of a case with necrosis of the subcutaneous and visceral fat. Arch Pathol 1948;45:278–288.
7.
Vasireddy S, Long SD, Sacheti B, Mayforth RD: MRI and US findings of subcutaneous fat necrosis of the newborn. Pediatr Radiol 2009;39:73–76.
8.
Hashimoto T, Noguchi T, Nagai K, et al: The organization of the communication routes between the epithelium and lamina propria mucosae in the human esophagus. Arch Histol Cytol 2002;65:323–335.
9.
Cohade C, Osman M, Pannu HK, Wahl RL: Uptake in supraclavicular area fat (‘USA-Fat’): description on 18F-FDG PET/CT. J Nucl Med 2003;44:170–176.
10.
Lichtenbelt WDM, Vanhommerig JW, Smulders NM, et al: Cold-activated brown adipose tissue in healthy men. N Engl J Med 2009;360:1500–1508.
11.
Chiba S, Katsuragi I, Shimada T, et al: Evaluation of human brown adipose tissue using positron emission tomography, computerised tomography and histochemical studies in association with body mass index, visceral fat accumulation and insulin resistance (abstract). Obes Rev 2006;7(suppl 2):87.
12.
Cannon B, Nedergaard J: Brown adipose tissue: function and physiological significance. Physiol Rev 2004;84:277–359.
13.
Avram AS, Avram MM, James WD, et al: Subcutaneous fat in normal and diseased states: 2. Anatomy and physiology of white and brown adipose tissue. J Am Acad Dermatol 2005;53:671–683.
14.
Dawkins MJR, Hull D: Brown adipose tissue and the response of new-born rabbits to cold. J Physiol 1964;172:216–238.
15.
Taieb A, Douard D, Maleville J: Subcutaneous fat necrosis and brown fat deficiency. J Am Acad Dermatol 1987;16:624–625.
16.
Taieb A, Enjolras O, Vabres P, Wallach D: Dermatologie néonatale. Paris, Maloine, 2009, pp 182–184.
17.
Kruse K, Irle U, Uhlig R: Elevated 1,25-dihydroxyvitamin D serum concentrations in infants with subcutaneous fat necrosis. J Pediatr 1993;122:460–466.
18.
Farooque A, Moss C, Zehnder D, et al: Expression of 25-hydroxyvitamin D3-1alpha-hydroxylase in subcutaneous fat necrosis. Br J Dermatol 2009;160:423–425.
19.
Suhonen-Polvi H, Ruotsalainen U, Kinnala A, et al: FDG-PET in early infancy: simplified quantification methods to measure cerebral glucose utilization. J Nucl Med 1995;36:1249–1254.
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2011
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