Harlequin color change in a premature infant: A case report

Clin Case Rep. 2023 Aug 24;11(9):e7840. doi: 10.1002/ccr3.7840. eCollection 2023 Sep.

Abstract

Key clinical message: This case of HCC report contributes to the knowledge of HCC in China. In this case, the longer duration of the color change observed in this case compared to previous reports, which will be useful for all medical practitioners.

Abstract: Harlequin color change (HCC) is a benign skin color change that lasts for a short time with no obvious physical abnormalities. Its pathogenesis is still unclear. It occurs in newborns, especially premature infants. However, few cases of HCC have been reported in China. Herein, we report a case of HCC. The infant was born at 34 + 4 weeks of gestation and was admitted to the hospital due to metabolic acidosis and neonatal pneumonia after birth. On the third day after birth, there were two red bands with obvious edges along the body centreline, and the erythema characteristics were consistent with those of HCC. The immature hypothalamus of newborns may cause the occurrence of HCC. At the same time, some drugs (midazolam), hypoxemia, and blood sampling may also be associated with HCC during neonatal hospitalization. All doctors should be thoroughly knowledgeable about the clinical characteristics of HCC and avoid using unnecessary drugs during treatment.

Keywords: blood extraction; compensatory acidosis; harlequin color change; midazolam; neonate.

Publication types

  • Case Reports