Management of a collodion baby – Our experience

Abstract

Collodion baby is a transient condition in newborns where they are covered in a taut, shiny membrane. Later, it can evolve into any form of autosomal recessive congenital ichthyosis or other ichthyosiform syndromes. Retinoids are one of the most effective therapeutic modalities for ichthyosis and have been found to be safe in neonates. Hence, early and judicious use of retinoids can significantly improve the quality of life in severe ichthyosis. Herein, we report a case of congenital ichthyosis which showed an excellent response to acitretin therapy.

Collodion Baby

“…Due to the impairment of skin barrier function, these neonates risk many complications, including hypernatremic dehydration, thermal instability like hypothermia, percutaneous toxicity, infection, fissures, conjunctivitis, sepsis, dehydration, and constriction bands of the extremities resulting in vascular compromise and edema. [15][16][17] There is a high risk of dehydration and electrolyte imbalances and high insensible water loss from the skin defect, requiring placement in a highhumidity incubator, close monitoring of body temperature, and good nutritional support in enteral and parenteral forms. [14][15][16] Placing collodion baby in the humidified incubator is essential, with the incubator humidity set at 40-70%.…”

“…Ampicillin and gentamicin were prescribed in both cases because of the high risk of sepsis neonatorum. 17 They were bathed with special soap containing lactic acid, lactoserum, and pH for normal skin. Artificial tears were prescribed twice a day for the first case, and levofloxacin eye drops and gentamicin eye ointment three times a day for the second case.…”

“…Management of this devastating condition requires a multidisciplinary approach the combined effort of dermatologists, neonatologists, and ophthalmologists. 10,17 The management strategy should focus on protecting skin barrier, infections control, maintenance of fluid and electrolyte balance, and early initiation of retinoid therapy, 17,19 accompanied with enhanced moisturization, electrolyte monitoring in the early neonatal period, sepsis prevention and physiotherapy, long term survival of 81% has been reported. 19 Both patients were continued to be under multidisciplinary surveillance and management.…”