Collodion baby

It is a 2 days old child born with extensive skin detachment and ulcerations, admitted 3 days ago in Cottolengo Mission Hospital.

He was born through simple vaginal delivery at a rural maternity located at about 50 Km from our facility.

There is oedema of the body, skin ulcerations and impressive ectropion at both eyelids. The skin looks thick, dry and similar to plastic. The oral mucosa is intact and the child is able to breast-feed.

The above condition was present at birth.

We have put a clinical diagnosis of collodion baby.

It is impossible to find a venous access due to the conditions of the skin, and therefore we are treating the child with oral medications: we have covered him with an oral cephalosporin, and we give paracetamol per os in case of fever. The collodion baby is actually very prone to sepsis.

The child is in a humidified incubator to regulate the body temperature, while preventing dehydration.

Surprisingly he is able to feed well, and we allow the mother to breast-feed him. We have also instructed her to add dextrose 5% per os, in order to further prevent dehydration.

We apply emollients on the skin to protect it from further cracks and further increase of ichtyosis.

Unfortunately we are not able to monitor the electrolytes because we have no vein available.

For what we have read in literature, we have very little hope to save the patient, even because retinoids are not available in our set up.

But we will do whatever we can.

Dr Giuseppe Gaido