October 1995

Picture of the Month

Author Affiliations

From the Department of Pediatrics, Atatürk Üniversity Faculty of Medicine, Erzurum, Turkey (Drs Selimoǧlu, Dilmen, Karakelleoǧlu, and Bitlisli), and the American Board of Pediatrics, Chapel Hill, NC (Dr Tunnessen).

Arch Pediatr Adolesc Med. 1995;149(10):1171-1172. doi:10.1001/archpedi.1995.02170230125020

MACULAR erythema developed on one half of the body of a full-term new-born with transient tachypnea on the third day of life (Figure 1). The color change lasted 10 minutes and was not associated with changes in vital signs. A similar change in body color developed in an otherwise healthy premature infant on the fifth postnatal day (Figure 2).

Denouement and Discussion 

Harlequin Color Change  The harlequin color change was first described by Neligan and Strang in 1952.1 Premature infants are more commonly affected than fullterm infants, but up to 10% of full-term infants may display this phenomenon, most commonly on the third or fourth days of life.2,3 The characteristic appearance is a macular erythema involving one half of the infant's body, with simultaneous blanching of the other half. This most commonly occurs when the infant is lying on his or her side, with the upper side pale and the

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