Keywords
Pediatrics
Malformations
Harlequin Phenomenon
How to Cite
Abstract
Background: The Harlequin phenomenon is characterized by a sudden change in skin color, dividing it into a pale half and a plethoric half with a boundary line along the body. It can be irregular, sparing areas such as the arms, legs, trunk, face and/or genitals. The condition is usually brief, with rapid reversal and return of the natural color within minutes.
Aim: To report a case of Harlequin phenomenon seen in our department.
Method: A newborn was seen at the Neonatology Department of the Hospital Universitário São Francisco na Providência de Deus - HUSF, Bragança Paulista, SP, Brazil.
Case Report: The patient H. H. R. S., a late preterm newborn of 36 weeks and 1 day, presented, in addition to neonatal hypoglycemia and breathing difficulties, the rare Harlequin phenomenon on the second day of life. The phenomenon manifested as hyperemia throughout the right hemisphere, with spontaneous improvement within 5 minutes, without the need for intervention. The patient continued to be hospitalized with cardiological follow-up and control of the septal hypertrophy, and was discharged on March 7 with instructions to follow up the case on an outpatient basis.
Conclusion: The case illustrates the importance of intensive management in newborns with complex conditions such as the Harlequin phenomenon, which requires rapid identification. The response to treatment allowed the baby to be discharged from hospital in good condition. Follow-up is essential to monitor septal hypertrophy and ensure the patient's healthy development.
References
CIZMECI, M. N. et al. Harlequin color change after abdominal paracentesis in a newborn with neonatal hemochromatosis. Pediatric Dermatology, v. 31, n. 6, p. e114-115, 2014.
HAMIDA, E. B.; AYADI, I. D. Harlequin color change in preterm infant. The Pan African Medical Journal, v. 22, p. 119, 2015.
JIANG, C.; LI, H. Localized Harlequin Color Change-Like Irritant Skin Reaction after Thoracentesis in an Adult. Indian Journal of Dermatology, v. 67, n. 6, p. 776–777, 2022.
KHEMANI, S. et al. Harlequin Colour Change. Journal of the College of Physicians and Surgeons--Pakistan: JCPSP, v. 27, n. 9, p. S127–S128, set. 2017.
PINEL GUZMÁN, E. et al. Harlequin color change in a newborn who was positive for COVID-19:: report of a case. Acta Médica Peruana, v. 40, n. 1, p. 62–65, 2023.
SELIMOĞLU, M. A. et al. Picture of the month. Harlequin color change. Archives of Pediatrics & Adolescent Medicine, v. 149, n. 10, p. 1171–1172, out. 1995.
SNYDER, K. A. M.; VOELCKERS, A. D. Newborn Skin: Part I. Common Rashes and Skin Changes. American Family Physician, v. 109, n. 3, p. 212–216, mar. 2024.
TSUBOI, K. et al. Neonatal Harlequin color change associated with Prostaglandin E1 administration. Pediatrics International: Official Journal of the Japan Pediatric Society, v. 63, n. 5, p. 610–611, maio 2021.
VALERIO, E. et al. Harlequin Color Change: Neonatal Case Series and Brief Literature Review. AJP Reports, v. 5, n. 1, p. e73–e76, abr. 2015.
VAN DEN BERG, G.; BAKKER, H. Harlequin Color Change in a Neonate. The New England Journal of Medicine, v. 382, n. 5, p. 456, 30 jan. 2020.
YANG, L. et al. Harlequin color change in a premature infant: A case report. Clinical Case Reports, v. 11, n. 9, p. e7840, set. 2023.
YILMAZ, C.; ENGÜR, D. Harlequin color change in the delivery room. Pediatric Academic Case Reports, v. 2, n. 1, p. 033–034, 2023.
This work is licensed under a Creative Commons Attribution 4.0 International License.