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AJP Rep 2015; 05(01): e73-e76
DOI: 10.1055/s-0035-1545671
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Harlequin Color Change: Neonatal Case Series and Brief Literature Review

Enrico Valerio
1   Department of Woman and Child Health, Medical School, University of Padua, Padova, Italy
,
Alessia Barlotta
1   Department of Woman and Child Health, Medical School, University of Padua, Padova, Italy
,
Eleonora Lorenzon
1   Department of Woman and Child Health, Medical School, University of Padua, Padova, Italy
,
Livio Antonazzo
1   Department of Woman and Child Health, Medical School, University of Padua, Padova, Italy
,
Mario Cutrone
2   Department of Pediatrics, Ospedale Dell'Angelo, Mestre, Venice, Italy
› Author Affiliations
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Publication History

22 October 2014

30 December 2014

Publication Date:
02 March 2015 (online)

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Abstract

First clinical report of Harlequin color change (HCC) phenomenon came in 1952 from Neligan and Strang. Since then, HCC has been described in a fairly broad number of clinical reports involving neonates, infants, children, and adult patients. We here present a small case series of HCC occurring in neonates, pointing out three of the different possible presentations (hemifacial, patchy scattered across the whole body, and hemiscrotal) of this phenomenon. A brief discussion and literature review encompassing epidemiology, clinical features, physiopathology, associated conditions, and differential diagnoses of HCC is then presented. In most cases, HCC represents a benign, idiopathic, and rapidly autoresolutive phenomenon, with no need for treatment. Some drugs (especially anesthetics and prostaglandin E) are thought to enhance HCC expression through their influence on the capillary tone in the peripheral vascular bed; this effect is anyway promptly reversible with drug withdrawal. Only in rare circumstances, HCC may act as a clue for serious central nervous system disorders (e.g., meningitis; hypothalamic, brain stem, or sympathetic nervous system lesions); anyway, in these rare occurrences HCC always represents an epiphenomenon of the disease, never acting as the sole sign of the underlying disorder.

Keywords

harlequin color change - preterm - neonate - infant - dermatology