Sclerema Neonatorum Clinical Presentation

Updated: Jun 25, 2018
  • Author: India Mayo Hill, MD; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

Half the infants affected by sclerema neonatorum are premature, and the others are full term but have a serious underlying illness. They are often of low birth weight (Apgar scores

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Physical Examination

Physical findings of sclerema neonatorum appear suddenly, first on the thighs and buttocks and then, spreading rapidly, often affecting all parts of the body except the palms, soles, and genitalia. The involved skin is pale, waxy, and firm to palpation. The skin cannot be pitted or pinched up because it is bound to underlying subcutaneous tissue, muscle, and bone. The affected infant often displays flexion contractures at the elbows, knees, and hips; temperature instability; restricted respiration; difficulty in feeding; and decreased spontaneous movement. Newborns may also present with masklike facies or “pseudotrismus,” an inability to completely open the mouth, secondary to the thickening of the skin over the face, arms, and hands. [14]

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Complications

Unless the underlying disease is identified and treated, the course of sclerema neonatorum is one of rapid deterioration in the general health of the infant and, ultimately, death.

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