Dr Shivani Sachdev Gour Views on Collodion Baby

Dr Shivani Sachdev Gour, Gynaecologist and IVF Specialist, SCI Healthcare shares her views on what is a collodion baby and what are the complications such babies face during this condition and how one can take care of them-

Collodion Baby -This is a rare condition in which a baby’s skin is covered by a yellowish tight shiny plastic sheath like membrane at birth (in laymen terms – a sausage skin or dried colloidon)

In approx 50% of cases it is due to genetic inheritance of a skin disease icthyosis. It is extremely rare condition with an incidence of approx 1 in 300,000

These babies are usually born premature and the diagnosis is extremely difficult before birth and in almost all cases has been made after birth. The characteristic skin appearance makes the diagnosis apparent and in some cases where the signs are subtle a biopsy of the skin is required.

Genetic counseling is mandatory for parents who have given birth to a colloidon baby.

This has been well described by Lopez in the Journal of Bio Med Hosp Infant

The most important clinical data concerning collodion baby is the presence of disseminated or generalized ichthyosiform genodermatosis characterized by dry skin, scaling, generalized erythroderma and hyperkeratosis, reminiscent of fish scales. This type of dermatosis is also known by the generic name of ichthyosis

The clinical types of ichthyosis depend on the mode of inheritance as well as clinical and anatomo-pathological data. 

Ichthyosis can be classified into three groups: 1) true ichthyosis, 2) ichthyosiformstates and 3) epidemolytic hyperkeratosis. There several subtypes of each group.

Colloidon baby is an extremely high risk baby. They are usually admitted to the Intensive care unit immediately after birth.  The first skin foundation has listed the following as risk factors

The collodion membrane cracks and peels over the course of several weeks. The tightness of the membrane may cause the eyelids to turn out revealing the pink inner lid; a condition called ectropion. Eclabium, the turning out of the lips due to the tightness of the membrane, may accompany the ectropion, and may cause difficulties with nursing. When the membrane is completely shed the infant may display one of several ichthyosis skin types. Congenital ichthyosiform erythroderma (CIE) and lamellar ichthyosis are the most commonly seen forms of ichthyosis presenting with a collodion membrane. However, the membrane may also be present in Netherton syndrome and other very rare forms of ichthyosis, and is always present with harlequin ichthyosis. A small percentage of infants shed the membrane and never display any other skin involvement; a phenomenon called “self-healing collodion baby.”

Collodion babies are at high risk of some complications. The cracking and peeling of the membrane increases the risk of infection from microorganisms. These infants are also at risk for fluid loss, dehydration, electrolyte imbalance, body temperature instability, and pneumonia.

Collodion babies should be placed in a high humidity chamber, and monitored closely for complications. A high humidity environment will allow slow, gradual sloughing off of the membrane. The membrane will come off on its own and should not be peeled off. 

Application of mild petroleum-based moisturizers may help the infant feel more comfortable while the membrane is peeling off.

Comments

  1. Dear Dr Shivani,

    Thank you so much
    Dr Shivani Sachdev Gour
    and
    SCI IVF Hospital
    for making our dream comes true.

    We had heard such horror stories about IVF & have been so surprised and thrilled with our experience & success in FIRST ATTEMPT.

    ReplyDelete

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