Case of the Month

This newborn baby has periods of erythema covering half of her face/head. These periods of ‘hemi-cephalic erythema’ occur on both sides of the face/head in the same baby, as these pictures of the same baby girl on different days depict. They can last a few seconds to a few minutes and then completely disappear! They can occur at any time but occur most commonly when the baby is lying down, on the dependent side of the head.

What's Your Diagnosis?

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Diagnosis: Harlequin color change: unilateral (transient) erythema in a newborn
(Transient Hemi-facial Erythema of Newborns)

Amazingly, this odd ‘half-head,' ephemeral flushing reaction has been reported to occur in 10% of all newborns. The reaction can last several seconds up to several minutes. The condition is harmless and is not a harbinger of any other health concerns. The condition usually appears in the first few days of life and almost always resolves within 4 weeks, if not sooner, without any additional appearances or complications. The condition can occur on both sides of the head, in the same newborn, as these pictures depict.

The exact cause is uncertain but noted Board Certified Dermatologist, Neil Shah, M.D. of Minnesota reports that he believes it is a result of a slightly immature autonomic nervous system that rapid catches up in a few days to weeks after birth resulting in a complete disappearance of the condition. No additional work-up is required.

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Reference:

US National Library of Medicine

A CLINICAL ATLAS OF 101 COMMON SKIN DISEASES
With Histopathologic Correlation
A. BERNARD ACKERMAN, HELMET KERL, JORGE SANCHEZ, YING GUO, ANGELIKA HOFER, PAUL KELLY, TETSU KIMURA, GIOVANNI BORRONI,CHARLES CRUTCHFIELD, VOLKER STEINKRAUS, WOLFGANG WEYERS

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