Kramer described the progression of skin involvement by jaundice in a neonate. There is a distal progression in color that correlates with the severity of hyperbilirubinemia.
Clinical Extent
Grade
none
0
limited to the head and neck
1
involves the (chest and upper abdomen) and/or back
2
involves the abdomen below the umbilicus to the knees
3
involves the legs below the knees and/or upper and lower arms
4
involves hands and/or feet
5
The more severe the hyperbilirubinemia the higher the grade.
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