Harlequin Color Change

This article is an answer to the Case – Skin Color Change in Newborn

The change in color, which persisted for a week, was consistent with harlequin color change — the development of redness on the dependent side of the body, with simultaneous blanching of the contralateral side.

Usually, this benign change in color is abrupt. Each episode tends to last between 30 seconds and 20 minutes and to resolve with increased activity.

Up to 10% of infants undergo this color change, which occurs between the second and fifth days of life. The shifts from normal to red color usually clear up completely within 3 weeks.

Harlequin color change is thought to be caused by aberrant dilatation of the peripheral vasculature, possibly as a result of incomplete development of the hypothalamus and temporary imbalance in autonomic regulation. The phenomenon is more common among low-birth-weight infants.