Skin cannot be pitted or picked up because it is bound to the underlying tissues. The affected infant often displays temperature instability, restricted respiration, difficulty in feeding, and decreased spontaneous movement. Laboratory abnormalities correlate with the underlying disease process. Hypoglycemia, metabolic acidosis, respiratory alkalosis, hyperkalemia, hypocalcemia, and elevated blood urea are common, albeit nonspecific, findings. A complete sepsis workup should be initiated in all infants.
Histologic findings are subtle.
The most consistent findings are edema, a thickening of the subcutaneous fibrous septa, and a radial array of fine needlelike clefts in the fat cells. The fat cells often are enlarged. In contrast to subcutaneous fat necrosis of the newborn, no fat necrosis or inflammation exists. Careful monitoring, correction of electrolyte abnormalities, respiratory support, correction of hypovolemia, and control of hypothermia are important. Some authors advocate the prompt institution of prophylactic broad-spectrum antibiotic therapy for possible associated sepsis.