The infant is born to a 31-year-old primigravida mother by cesarean delivery due to nonreassuring fetal heart rate and chorioamnionitis. Rupture of membranes is prolonged at 47 hours with meconium-stained amniotic fluid. At birth, the newborn is noted to have poor tone and respiratory effort. He undergoes intubation and is admitted to the NICU for further observation and management. Apgar scores are 2, 5, and 7 at 1, 5, and 10 minutes, respectively. Arterial cord gas has a pH of 6.8 and a base deficit of 24 mEq/L (24 mmol/L). The patient demonstrates signs and symptoms of moderate hypoxic-ischemic encephalopathy and meets the criteria for whole body hypothermia therapy. He is started on parental nutrition. He has evidence of pulmonary hypertension on echocardiography and requires inhaled nitric oxide for 2 days while undergoing hypothermia treatment. He maintains adequate blood pressures and does not have any hemodynamic decompensation. He receives 2 doses of fresh frozen plasma to correct laboratory indices that demonstrate abnormal coagulation profiles. Following rewarming and after obtaining a brain magnetic resonance imaging scan (which is unremarkable) he undergoes successful extubation on the 4th postnatal day. His respiratory support is gradually weaned and he remains in room air from day 6 of age onwards. He is slowly introduced to enteral feeds and reaches full oral feeds by 9 days of age. His neurologic examination findings are normal. Erythematous, indurated plaques are noted over the upper back, …