The differential diagnosis of SCFN can be broad, and clinicopathologic correlation is essential to make the correct and timely diagnosis so that appropriate measures can be taken to prevent the potential serious complication hypercalcemia.
Skin and subcutaneous infection generally manifests in warmth, swelling, and pain of the lesion, whereas SCFN remains normothermic to palpation.
The clinical appearance of cold panniculitis may overlap with early stage SCFN. It usually has no maternal factors and tends to occur within 72 hours of cold exposure.
Unlike SCFN, which has aforementioned risk factors, sclerema neonatorum usually has no maternal factors with an uneventful delivery and is often associated with congenital anomalies, serious respiratory illness, and sepsis.
Histopathologically, poststeroid panniculitis can mimic SCFN by displaying a mixed inflammation of less intensity, as well as needle-shaped clefts in adipocytes and histiocytes.
The pathogenesis of SCFN and hypercalcemia is unclear.
The most popular hypothesis of hypercalcemia in SCFN is the extrarenal production of 1, 25-[(OH).sub.2][D.sub.3], leading to increased intestinal absorption of calcium.