What is Harlequin's Sign?

Victoriakem · Sep 28, 2004

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

cannoli · Sep 28, 2004

If you use the search engine Monster Crawler and type it in a site which mentions it does come up.

http://www.russianadoption.org/Neurologicalexaminationnewbornsandinfants.htm

weetziebat · Sep 28, 2004

KittyKat,

When I worked in NBICU we would occasionally see babies with this. It was as though you'd drawn a line down the center of their body and on one side the skin was red and on the other they were white. And I mean a big difference. Don't remember though what the cause is.

Good luck on the test :)

Gompers, BSN, RN · Sep 28, 2004

I've been trying to find a picture of it on the internet for you, but I can't seem to track one down. As a NICU nurse, I've seen this happen quite a few times and it's pretty remarkable when you see it. It has to do with the fragility of a newborn's blood vessels during the immediate newborn period.

Here's a link explaining it, best I could do:

http://www.drgreene.com/21_494.html

wonderbee, BSN, RN · Sep 28, 2004

Thanks for the replies. Sounds dramatic and scary to the uninformed new mom. I will not forget this one.

CCU NRS · Sep 28, 2004

KittyKat,
When I worked in NBICU we would occasionally see babies with this. It was as though you'd drawn a line down the center of their body and on one side the skin was red and on the other they were white. And I mean a big difference. Don't remember though what the cause is.
Good luck on the test :)

This concurs with what my Tabers's says, be aware of Harlequin's Sign

differentiation between

Harlequin's fetus which is much more severe and the neonate has toad like horny skin with deep red lines and usually fatal within hours of birth

No cause for either listed in Taber

Ta DA I learneed something, I have nevr worked OB except my clinicals and here I am learning imagine that.

BittyBabyGrower, MSN, RN · Sep 28, 2004

It is a type of vasomotor response...it is pretty astounding to see! It is exactly as someone else said...the baby is divided in half..one half either pale or pink and the other mottled or ruddy.

Most Harlequin syndromes don't live

veteranRN · Sep 28, 2004

I saw a picture of it once in a medical dictionary and had nightmares afterwards. It looked kinda scary and obviously the baby in the photo was deceased.

Gompers, BSN, RN · Sep 28, 2004

I saw a picture of it once in a medical dictionary and had nightmares afterwards. It looked kinda scary and obviously the baby in the photo was deceased.

Remember, Harlequin's sign is a harmless thing that only happens within the first few hours of a baby's life, a vasomotor response, like BittyBabyGrower said. Here's a photo I found on Google - it's not the best, but you can kind of see the color change. It looks more dramatic in person.

http://162.129.70.33/images/scan_039.jpg

Harlequin's Fetus, aka Harlequin Ichthyosis, is a horrible birth defect that is always fatal. There was an article in Neonatal Network last year, I think, that outlined the comfort care provided for these poor souls. It's very frustrating, as it's almost impossible to place or keep an IV secured in these babies, so analgesia is an issue.

For anyone who is interested, this is a website about that condition. DO NOT click on this unless you are truly intersted in learning more. It's VERY disturbing for most people to see the photos provided.

http://asylumeclectica.com/malady/archives/harlequin.htm

wonderbee, BSN, RN · Sep 29, 2004

Remember, Harlequin's sign is a harmless thing that only happens within the first few hours of a baby's life, a vasomotor response, like BittyBabyGrower said. Here's a photo I found on Google - it's not the best, but you can kind of see the color change. It looks more dramatic in person.
http://162.129.70.33/images/scan_039.jpg
Harlequin's Fetus, aka Harlequin Ichthyosis, is a horrible birth defect that is always fatal. There was an article in Neonatal Network last year, I think, that outlined the comfort care provided for these poor souls. It's very frustrating, as it's almost impossible to place or keep an IV secured in these babies, so analgesia is an issue.
For anyone who is interested, this is a website about that condition. DO NOT click on this unless you are truly intersted in learning more. It's VERY disturbing for most people to see the photos provided.
http://asylumeclectica.com/malady/archives/harlequin.htm

Those poor wee little souls.

BETSRN · Sep 29, 2004

Red marks on the forehead (and other places) are called "stork bites."