Author: Dr Shadi Habib, Dermatologist, Ibn al-Walid Hospital, Homs, Syria (2023)Reviewing dermatologist: Dr Ian Coulson
Edited by the DermNet content department
A 6-hour-old male neonate presented with a shiny membrane covering his body since birth. The baby was born at term and was the second child in the family with the same skin abnormality.
On examination, the whole body was covered with a plastic-like membrane, which started to peel off on the face, chest, and intertriginous areas.
Associated findings included ectropion (outward turning eyelid), claw-like hands, and limitation of joint movements. The hair and nails were not affected, and no other congenital anomalies were detected. Blood panel and urinalysis were within the normal range.
The likely diagnosis is collodion baby, a rare congenital disorder due to a mutation of certain genes which manifest as a tight, clear sheath covering their skin called a collodion membrane, that usually dries and peels off during the first few weeks of life.
The most common underlying diseases:
Other rarer conditions that may present with a collodion membrane include:
10% of collodion babies have normal underlying skin – a mild presentation known as ‘self-healing’ collodion baby.
Management requires the expertise of a dermatologist and the paediatric team. The baby is initially kept in a humidified, neutral-temperature environment like an incubator. Other supportive treatments such as intravenous fluid and tube feeding may also be required to maintain hydration and nutrition. The skin should be kept soft to try and reduce scaling. The collodion membrane must not be debrided.
Treatment may include:
Collodion babies are at high risk of complications. The cracking and peeling of the membrane increases the risk of infection from microorganisms.
These infants are also at risk for:
Prognosis depends upon the particular underlying condition.
