Involvement of brown adipose tissue in subcutaneous fat necrosis of the newborn

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Subcutaneous fat necrosis (SCFN) of the newborn is a rare condition that is manifest within days of birth. The interscapular region, axillae and shoulders are the most commonly affected sites, corresponding to anatomic sites of brown fat tissue (BAT) in newborns. We postulated the specific involvement of BAT in SCFN and searched for brown adipocytes at affected sites. Biopsy specimens were immunostained with antibodies against uncoupling protein 1 (UCP-1) and examined by electron microscopy. We also examined BAT by 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomographic and computed tomographic (PET-CT) scanning. A few cells in biopsy specimens from two patients bound antibodies against UCP-1, and brown adipocytes were detected at several stages of degeneration. PET-CT scans revealed lower uptake of 18F-FDG at major sites of SCFN. SCFN and BAT can be found in the same sites, suggesting a pathophysiological connection.