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pediatric case

Discussion in 'Spot Diagnosis' started by bb100, Apr 13, 2013.

  1. bb100

    bb100 Bronze Member

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    What is your diagnosis?

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  2. neo_star

    neo_star Moderator

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    Ans: Collodion Baby

    Clue to diagnosis - baby seems to be covered in a parchment like membrane

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    Xtra Edge

    Ichthyosis in the newborn often presents as a collodion baby. It is not a distinct disorder, but can be the first presentation of several (usually autosomal recessive) ichthyoses.
    At birth, the collodion baby is encased in a clear, parchment like membrane, which may impair respiration and sucking.When the membrane is shed 2 to 3 weeks later, the infant may have difficulties with thermal regulation and an increased susceptibility to infections. After healing the skin will appear normal. Sixty to
    seventy percent of these babies will go on to develop some form of ichthyosis later in life.


    ref - color Atlas ans synopsis of Pediatric Dermatology

    Please note: "Collodion baby" is often referred to as "Lamellar Ichthyosis", which is incorrect becos not all Collodion babies have lamellar ichthyosis. Lamellar ichthyosis is just a type of collodion baby with transglutaminase-1 deficiency leads to abnormal cornification which causes the membrane. So at birth we can't be sure ( unless we have specifically tested for it ) and we can safely call it by the umbrella term "Collodion Baby"


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    Differentials

    1) normal vernix caseosa - it has a waxy, petrolatum jelly ( Vaseline ), kind of texture and is easily wiped off.

    2) Harlequin Ichthyosis - the most xtreme form of cong. ichthyosis and is characterised by armor like scales ( almost looks like a tortoise shell ).
     

  3. Emergency medicine Mike

    Emergency medicine Mike Bronze Member

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  4. bb100

    bb100 Bronze Member

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    Correct Answer :collodion membrane
     

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