What is scleredema neonatorum?

It is typically seen in newborns but has been reported in infants up to 3 months of age. Clinically, it presents as a hardening of the skin with decreased temperature, vascular mottling, and a yellow-white discoloration in a symmetrical distribution, usually over the thighs and trunk. It usually occurs in the setting of an underlying severe illness and is associated with a 50% mortality rate.

The pathophysiology of this sign probably is initiated by decreased body temperature that results in the hardening and solidification of the subcutaneous fat. This occurs in newborns because they have increased amounts of saturated lipids in their fatty tissue that solidify at higher temperatures than normal fat. Because this clinical condition often heralds death, it is important to recognize this entity early and aggressively treat the underlying illness.