What is Harlequin's Sign?

Specialties Ob/Gyn

Published

I have an OB test on Thursday. What is Harlequin's sign as it relates to the newborn? The net is not helping me.

Thanks.

Specializes in NICU.

I've seen the Harlequin sign several times, maybe within a half hour of birth. It looks strange, but usually comes and goes very quickly.

I hope that I never see one of those poor Harlequin Ichythosis babies. It's a blessing when they die.

Up Vote Up Vote ×

I've only seen Halequin's sign once and the kiddo was OK. They other I hope to never see.

Up Vote Up Vote ×
Specializes in PERI OPERATIVE.

Poor loves...

Up Vote Up Vote ×

My oldest son had the Harlequin's sign which is pretty remarkable when you see it. I had propped him on his side and the bottom side turned deep red while the upper side was white! This only happened when he was on his side. This sign vanished after a few days...scared me alot when I saw it! He's fine--16 years old and a head taller than me!

Up Vote Up Vote ×
Isn't Harlequin's sign those red marks on the babies' forehead? They are supposed to resolve after 1-2 yrs.

I think you mean "stork bites". Harlequin's sign is a deep pink coloring on the dependant side of the body with paleness on the other side. This sign has no pathological significance. I have seen some dramatic instances of Harlequin's sign but they all resolved fairly quickly with no consequences whatsoever.

Up Vote Up Vote ×

My very healthy, but Down's Syndrome, 9 month old nephew was visiting. His mom treated him like he was "going to break" all the time, like he was delicate and fragile like a piece of glass. I suggested she instead treat him as she did her other child, only even moreso. (Like working with PT to strengthen his limbs his breathing, etc. rather than keeping him at home, in a car seat or stroller all the time). We all went to the pool. I, the eternal optimist. insisted the kid be hauled into the children's pool with all our other children. He LOVED the water, kicking and splashing everywhere....BUT after about 30 minutes, he deveolped a vivid Harlequin's Sign! We couldn't miss it! One half of him was pale pink, and one half of him was CYANOTIC BLUE! Of course, we hauled his cute little butt out of the water, and warmed him up pronto! I am NOT a peds nurse, but I had her get him to a cardiologist within the week...Yup, sure enough, he had cardiac defects that had been overlooked to that point! He since has had two major surgeries and is doing well.

We tease each other that either I nearly killed the kid by freezing him in the pool OR I saved his life by noticing the Harlequin's Sign and getting him to a proper cardiologist.

Haze

Up Vote Up Vote ×

I vote for the fact that you saved his life!! What a lucky boy to have such an astute aunt. I guess I should have qualified my answer to say that Harlequin's sign in a newborn is not considered pathological....if it continues beyond that phase then it is something to look into.

Up Vote Up Vote ×
Specializes in NICU.
I guess I should have qualified my answer to say that Harlequin's sign in a newborn is not considered pathological....if it continues beyond that phase then it is something to look into.

Exactly! In the first day of life it's okay...after that, no!

Up Vote Up Vote ×

it is when you placed the baby on the other side and after a while when you turned it there is red in that part...

Its normal for the baby:D

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

thanks for the excellent and informative post, Gompers!

Up Vote Up Vote ×
+ Add a Comment