Peds

Harlequin Color Change

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Harlequin Color Change

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