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Harlequin Color Change

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Harlequin Color Change, Harlequin Skin Reaction

  • See Also
  1. Newborn Skin Exam
  • Definitions
  1. Harlequin Color Change
    1. Normal newborn Skin Color response to position change with dependent erythema
  • Epidemiology
  1. Affects 10% of newborns within the first few weeks of life
  • Physiology
  1. Immature Hypothalamus with inconsistent regulation of peripheral vessels
  • Risk Factors
  1. Premature Infants
  2. Head Injury
  • 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. Timing
    1. Onset in first 3 to 5 days of life
    2. Episodes last from 1 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]
  3. Snyder (2024) Am Fam Physician 109(3): 212-6 [PubMed]