Harlequin Color Change in a Neonate

This image-based clinical report describes a male neonate born at 35 weeks’ gestation with a prenatal diagnosis of Ebstein’s anomaly who developed respiratory distress after birth. Echocardiographic and CT imaging revealed severe right-sided cardiac anomalies, including tricuspid dysplasia, pulmonary atresia, cardiomegaly, and pulmonary hypoplasia. On day three, the infant developed a sharply demarcated unilateral erythema a phenomenon known as Harlequin color change. The condition was benign, transient, and resolved spontaneously. It is sometimes linked to vasoactive medications such as alprostadil but remains an unexplained physiological occurrence. The clinical episode had no associated changes in vital signs or symptoms requiring intervention.

This image-based clinical report describes a male neonate born at 35 weeks’ gestation with a prenatal diagnosis of Ebstein’s anomaly who developed respiratory distress after birth. Echocardiographic and CT imaging revealed severe right-sided cardiac anomalies, including tricuspid dysplasia, pulmonary atresia, cardiomegaly, and pulmonary hypoplasia. On day three, the infant developed a sharply demarcated unilateral erythema a phenomenon known as Harlequin color change. The condition was benign, transient, and resolved spontaneously. It is sometimes linked to vasoactive medications such as alprostadil but remains an unexplained physiological occurrence. The clinical episode had no associated changes in vital signs or symptoms requiring intervention.