Cases Of Subcutaneous Fat Necrosis Research Articles

Posterior endoscopic decompression combined with anterior cervical discectomy and fusion versus posterior laminectomy and fusion for multilevel cervical spondylotic myelopathy: a retrospective case-control study

ObjectiveTo compare the clinical efficacy of surgical treatment for multilevel cervical spondylotic myelopathy (MCSM) between the hybrid procedure, posterior endoscopic decompression (PED) combined with anterior cervical discectomy fusion (ACDF), and posterior cervical laminectomy and fusion (PCLF).MethodsA retrospective analysis was performed on 38 patients who received surgical treatment for MCSM from January 2018 to December 2021, including 19 cases in hybrid procedure group (13 males and 6 females), followed up for 10 to 22 (12.8 ± 10.3) months, and 19 cases in PCLF group (15 males and 4 females), followed up for 10 to 21 (11.7 ± 8.9) months. Perioperative information, including operation time, intraoperative blood loss, length of hospitalization, and complications, were compared between two groups. Visual analogue scale (VAS) of pain, neck disability index (NDI) and Japanese Orthopaedic Association (JOA) score were recorded to evaluate clinical efficacy. Cervical lordosis was calculated by radiographic examination.ResultsIntraoperative blood loss, length of hospital stay were less in hybrid group than PCLF group, while operation time is longer in hybrid group, with a statistically significant difference (p < 0.05). Increased lordosis was better in hybrid group. There was no significant difference in preoperative VAS, JOA and NDI at pre-operation and final follow-up between two groups. But at post-operation and final follow-up, VAS was less in hybrid group than PCLF group (p < 0.05). There were 2 cases of neurostimulation symptoms in hybrid group, 2 cases of C5 nerve root palsy, 2 cases of subcutaneous fat necrosis and 1 case of dural tear in PCLF group, and all patients relieved with symptomatic treatment.ConclusionThe hybrid procedure of PED combined with ACDF showed satisfied clinical outcome, with less intraoperative blood loss, shorter length of hospitalization and lower post-operative neck pain than PCLF. It is an effective surgical treatment for MCSM.

Neonatal hypercalcemia secondary to subcutaneous fat necrosis presenting as severe dehydration

Subcutaneous fat necrosis (SCFN) is a rare fat tissue inflammation of the newborn that generally occurs in term or postterm newborns exposed to perinatal stressing factors such as cord prolapse, perinatal asphyxia, therapeutic hypothermia, meconium aspiration, and sepsis. Although most cases of SCFN resolve spontaneously, SCFN may be associated with symptomatic hypercalcemia presenting as lethargy, hypotonia, irritability, vomiting, polyuria, polydipsia, constipation, and dehydration. We describe a case of newborn affected with the disease, its presentation, clinical course, and treatment.

Necrose adiposa do recém-nascido: a propósito de dois casos clínicos

Subcutaneous fat necrosis of the newborn is an uncommon disorder occurring during the prenatal stage. Generally occurring in full-term neonates or during the first four weeks after a traumatic delivery, the disorder is characterized by the appearance of hard subcutaneous nodules or plaques on the trunk, buttocks or thighs. It is normally a benign and transient condition, although it may be complicated by hypocalcemia, which requires close monitoring until skin lesions are cured. The authors describe two cases of subcutaneous fat necrosis of the newborn, one occurring in a full-term neonate and the other in a premature newborn, both related to traumatic delivery and fetal distress.

Subcutaneous Fat Necrosis After Moderate Therapeutic Hypothermia in Neonates

Therapeutic moderate hypothermia in newborns with hypoxic-ischemic encephalopathy is rapidly becoming standard clinical practice. We report here 12 cases of subcutaneous fat necrosis among 1239 cases registered with a national registry of newborns treated with moderate whole-body hypothermia. All the infants suffered from perinatal asphyxia and hypoxic-ischemic encephalopathy. Moderate-to-severe hypercalcemia was identified in 8 of 10 infants with blood calcium measurements. In all cases the skin lesions appeared after completion of the cooling treatment. Our data suggest that prolonged moderate hypothermia is an actual risk factor for subcutaneous fat necrosis. Because the lesions often develop several days after birth, physicians need to be aware of this condition as a possible complication in infants treated with moderate hypothermia after asphyxia. Blood calcium levels need to be monitored in affected infants.

Reply to the correspondence letter by Hakan N et al. alendronate for the treatment of hypercalcaemia due to neonatal subcutaneous fat necrosis

We thank Dr. Hakan and collaborators for their interesting information provided as a reaction to our recent paper [1]. Their approach is original, although their hypothesis needs to be discussed in further details. Biphosphonates are adsorbed on to hydroxyapatite crystals in bone and slow down their rate of growth and dissolution. As a result, the rate of bone turnover decreases. Previously, other bisphosphonates, e.g., pamidronate, have been given in several cases of subcutaneous fat necrosis and found to be effective in hypercalcaemia–hypercalcuria conditions. Although biphosphonates are generally preserved for the more resistant cases and considered as second line agents for the treatment of subcutaneous fat necrosis in newborns, some have suggested that early use can prevent nephrocalcinosis. Alendronate is a new addition to the series of bisphosphonates tried for SCFN. This case report appears to be the first one reporting alendronate sodium use in SCFN. But it is not clear why this one was chosen among the bisphosphonates and whether it has got any superiority in comparison to the use of pamidronate while treating SCFN. As the physiopathological mechanism of SCFN is still not fully understood, the impact of alendronates on the natural history of SCFN and its long-term side effects need to be carefully monitored and its safety needs to be clearly established in the vulnerable neonatal population.

Subcutaneous fat necrosis in a newborn following icebag application for treatment of supraventricular tachycardia

Cases of subcutaneous fat necrosis of the newborn (SCFN) and neonatal cold panniculitis have been reported most often secondary to perinatal distress or hypothermia. We present a case of a newborn infant who developed erythematous, indurated plaques on both cheeks and right shoulder following ice pack application for supraventricular tachycardia. The distinction between SCFN and cold panniculitis is important as SCFN may have complications such as hypercalcemia, whereas cold panniculitis is not associated with such sequelae. Clinicians should be aware of the diagnostic similarities and differences between these two conditions because of differences in potential serious sequelae.

Subcutaneous fat necrosis: Report of two cases

Subcutaneous fat necrosis of the newborn is an uncommon, benign process in full-term infants or postmature neonates who experienced a perinatal distress. It is a transient condition of unknown origin; however, hypercalcemia may be a potentially life-threatening complication of this otherwise self-healing process. We report two cases of subcutaneous fat necrosis and discuss the clinical features, etiology, and complications of the disease.

Subcutaneous fat necrosis of the breast

Our objective was to report the mammographic and sonographic appearance of four patients with superficial subcutaneous fat necrosis of the breast. This type of fat necrosis of the breast is poorly known. We retrospectively reviewed all of the clinical and pathological information, as well as the radiological studies, on four cases of subcutaneous fat necrosis of the breast. Mammograms and sonograms were available for review in all cases. Diagnosis was made by excisional biopsy in three patients and fine-needle aspiration in the other. The lesions were apparent clinically as a palpable mass, and were not seen at mammography. At high-frequency US each lesion was identified as an ill-defined area of increased echogenicity of the subcutaneous fat. The authors believe the sonographic appearance to be suggestive of subcutaneous fat necrosis of the breast.

SUBCUTANEOUS FAT NECROSIS OF THE NEW-BORN

The various types of subcutaneous induration occurring in new-born or young infants have been the source of a good deal of confusion. During the past decade, however, knowledge of the subject has been considerably increased by histologic and chemical examinations. The type of induration that is the subject of this paper should. I think, be termed subcutaneous fat necrosis of the new-born, though it is still spoken of as sclerema neonatorum by some British and American writers. In many of these cases at the present time the confusion is merely one of nomenclature. Much confusion has also resulted from the reports of cases of scleroderma neonatorum which were manifestly not scleroderma but in all probability cases of subcutaneous fat necrosis. I shall discuss this subject later. The four principal types of subcutaneous induration to be considered are the following: adiponecrosis subcutanea neonatorum, sclerema adiposum (sclerema neonatorum),