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| Fig. 19.5 A, Subcutaneous fat necrosis of the left upper arm in an otherwise healthy infant. B, Biopsy of subcutaneous fat necrosis demonstrating characteristic fat destruction with needle-shaped clefts that induce a foreign body reaction consisting of macrophages and multinucleated giant cells. (Courtesy of James E. Fitzpatrick, MD.) |
Both conditions show needle-shaped clefts within lipocytes, presumably representing triglyceride crystals that have been dissolved during tissue processing. Sclerema neonatorum tends to show thickened fibrous septa and little inflammation, while subcutaneous fat necrosis shows a substantial lobular panniculitis with a foreign body reaction to the needle-shaped clefts (Fig. 19-5B).
