The harlequin color change is an uncommon, transient erythema that affects newborn infants. It may be due to an imbalance in the autonomic control in the blood vessels.
NOTE: The harlequin color change is different from the harlequin fetus, which is a form of congenital ichthyosis with massive scaly plates.
If the fetus is positioned on his/her side, the dependent half of the body becomes erythematous while the upper half is pale, with the line of demarcation along the sagittal midline.
The color change may be transient or persist for several minutes.
The pattern changes with a change in position.
Differential diagnosis:
(1) erythematous drug reaction
(2) chemical or thermal scald
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