Collodion baby (Fig. 4.2)
This is a description and not a diagnosis. The bizarre skin charges are seen at birth. At first the stratum corneum is smooth and shiny, and the skin looks as though it has been covered with cellophane or col-lodion. Its tightness may cause ectropion and feeding difficulties. The shiny outer surface is shed within a few days leaving behind, most often, a non-bullous ichthyosiform erythroderma, and less often a lamellar ichthyosis.
Problems with temperature regulation and high water loss through the skin in the early days of life are best dealt with by the use of a high humidity incubator. Regular applications of a greasy emollient also limit fluid loss and make the skin supple. The much rarer ‘harlequin fetus’ is covered with thick fissured hyperkeratosis. Ectropion is extreme and most affected infants die early.