Panniculitis in Infants

Abstract

To the Editor.— Katz et al 1 recently reported an unusual case of subcutaneous fat necrosis of the newborn (SQFN) presenting as a solitary anterior chest nodule. Several statements were made that merit further discussion. The authors implied that SQFN is a benign entity, especially in comparison to sclerema neonatorum (SN). Sclerema neonatorum is defined as "... a condition which, unlike SQFN, has a fatal outcome." Death, however, is not the inevitable consequence of SN. 2,3 Moreover, there is significant morbidity and even mortality associated with SQFN. 4,5 The etiology and pathogenesis of panniculitis in infants remains elusive. Sclerema neonatorum and SQFN can easily be differentiated on clinical grounds, but whether or not they are different manifestations of the same underlying pathologic process is moot. Although SN and SQFN most commonly occur shortly after birth, onset may be delayed. 3,5 Such variability in time of onset makes analysis of causal relationships