Collodion baby

Collodion baby

In medicine, the term collodion baby applies to newborns who appear to have an extra layer of skin that has a collodion-like quality. It is a descriptive term, not a specific diagnosis or disorder (as such, it is a syndrome). The appearance is often described as a shiny film looking like a layer of vaseline. The eyelids and mouth may have the appearance of being forced open due to the tightness of the skin. There can be associated eversion of the eyelids (ectropion).

Collodion baby can have severe medical consequences, mainly because the baby can lose heat and fluid through the abnormal skin. This can lead to hypothermia and dehydration. Strategies to prevent these problems are the use of emollients or nursing the baby in a humidified incubator. There is also an increased risk of skin infection and mechanical compression, leading to problems like limb ischemia. There is also a risk of intoxication by cutaneous absorption of topical products, for example salicylate intoxication (similar to aspirin overdose) due to keratolytics.

The condition is not thought to be painful or in itself distressing to the child. Nursing usually takes place in a neonatal intensive care unit, and good intensive care seems to have improved the prognosis markedly.

The appearance can be caused by several skin diseases, and it is most often not associated with other birth defects. In some cases, the baby sheds this layer of skin and has normal skin for the rest of its life. In most cases, the baby develops an ichthyosis or ichtyosis-like condition or other rare skin disorder. Known causes of collodion baby include lamellar ichthyosis, ichthyosis vulgaris and trichothiodystrophy. The condition can resemble but is different from harlequin type ichthyosis. Less well documented causes include Sjögren-Larsson syndrome, Netherton syndrome, Gaucher disease type 2, congenital hypothyroidism, Conradi syndrome, Dorfman-Chanarin syndrome, ketoadipiaciduria, koraxitrachitic syndrome, ichthyosis variegata and palmoplantar keratoderma with anogenital leukokeratosis. Since many of these conditions have an autosomal recessive inheritance pattern, they are rare and can be associated with consanguinity.

Tests that can be used to find the cause of collodion baby include examination of the hairs, blood tests and a skin biopsy.

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