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S. A. Dawe, R. Edwards, J. S. Williams, E. Higgins, Painful skin induration in a neonate, Clinical and Experimental Dermatology, Volume 30, Issue 5, 1 September 2005, Pages 607–608, https://doi.org/10.1111/j.1365-2230.2005.01887.x
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Extract
Conflict of interest: none declared.
Clinical findings
A 2‐month‐old Afro‐Carribean child of non‐consanguineous parents presented with a progressive lesion over the back first noticed shortly after birth (Fig. 1). Indurated mobile nodules were visible over the central upper back with overlying hyperpigmentation. Towards the lower back, the parents had noticed resorption of the nodules to leave an indented scar, and that touching the skin over the induration caused the child to cry. The child was otherwise well. Her birth had been complicated by a baseline tachycardia and decelerations on cardiotocogram, resulting in an assisted delivery with ventouse. At delivery, there was evidence of meconium‐stained fluid, and, amid concerns that the child might have aspirated meconium, she underwent a short stay with monitoring in the special care baby unit and a 5‐day course of penicillin and gentamicin.
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Histopathological findings
A diagnostic punch biopsy was performed from the indurated plaque on the back. Low‐power view of a skin biopsy from the upper back showed an essentially normal dermis, a mixed inflammatory infiltrate in the subcutis with fat necrosis (Fig. 2), and multinucleated giant cells containing needle‐shaped clefts arranged in a radial pattern (Fig. 3, indicated by arrow).
