II. Definitions
- Harlequin Color Change
- Normal newborn Skin Color response to position change with dependent erythema
III. Epidemiology
- Affects 10% of newborns within the first few weeks of life
IV. Physiology
- Immature Hypothalamus with inconsistent regulation of peripheral vessels
V. Risk Factors
VI. Symptoms
- Episodic Skin Color change after a child was lying on their side
- Appears as if half their body (dependent side) is deep red and the opposite pale white
- Timing
- Onset in first 3 to 5 days of life
- Episodes last from 1 to 20 minutes and resolves with movement or crying
VII. Signs
- Skin erythema on the side of body that is dependent (down)
- Skin blanching on the non-dependent opposite side (up side)
VIII. Management
- No intervention or evaluation is required
- Spontaneously resolves
IX. References
- Claudius and Behar in Herbert (2020) EM:Rap 20(8): 5-7
- O'Connor (2008) Am Fam Physician 77:47-52 [PubMed]
- Snyder (2024) Am Fam Physician 109(3): 212-6 [PubMed]