What is the cause of Harlequin color change (Harlequin syndrome)?

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From the Research

Harlequin color change is a benign and transient skin condition that does not require treatment, as it typically resolves on its own within minutes to hours without intervention. This condition is characterized by a sudden change in skin color, resulting in one half of the body appearing red while the other half remains pale, and is most commonly seen in newborns, particularly premature infants 1. The exact cause of harlequin color change is unknown, but it is thought to be related to immature blood vessel regulation and the effects of gravity on blood flow when a baby lies on their side 2.

Some key points to consider when evaluating harlequin color change include:

  • The condition is usually benign and self-limiting, with no need for treatment 3, 1
  • It can be alarming to witness, but simply repositioning the baby will usually cause the color difference to fade 1
  • If the color change persists for extended periods, becomes very frequent, or is accompanied by other concerning symptoms, medical evaluation should be sought to rule out other conditions 4
  • Harlequin color change has been associated with certain medications, such as prostaglandin E1, but discontinuation of these medications is not necessary unless other concerning symptoms are present 5

In terms of management, no treatment is necessary for harlequin color change, and parents should be reassured that this is a normal physiological response in some newborns. However, if the color change is accompanied by other concerning symptoms, such as difficulty breathing or poor feeding, medical evaluation should be sought to rule out other conditions 4. Overall, harlequin color change is a benign and transient condition that does not require treatment, and parents should be reassured that it is a normal physiological response in some newborns.

References

Research

Harlequin Colour Change.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2017

Research

The Harlequin phenomenon.

Journal of the European Academy of Dermatology and Venereology : JEADV, 2011

Research

Harlequin color change in two preterm newborns.

The Journal of dermatology, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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