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BACKGROUND
A 9-year-old boy presented with his father to United States military medical providers near a remote village in central Afghanistan. Having heard that American physicians were working in the area, the father traveled with his son to our location, seeking definitive medical treatment. The brief history obtained from the father was significant for the child having this condition from birth. The father did not report the child having an external layer of fibrous tissue at birth (collodion membrane) (Berhman, 2004). When asked, he denied any increase in the number of skin infections in his child.
On physical examination, the child had normal vital signs. Skin examination revealed generalized scales, which ranged from fine and white to thick, dark, and platelike. The above image depicts the patient's chest. Complete evaluation revealed scaling from his ankles to his face, sparing his scalp, inguinal region, the most posterior gluteal region, and the lower face. The lips and mucous membranes were spared. The scales seemed to be increased on the flexural surfaces and were largest on the lower extremities. The gross eye/facial exam was notable for classic ectropion. The rest of the examination findings, including cardiovascular and respiratory results, were unremarkable.
What is the diagnosis?
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Hint
Some infants are covered in a collodion sheath.
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Author:
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Daniel Sutton, MD,
Diving Medical Officer,
United States Navy |
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eMedicine
Editor:
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Rick G. Kulkarni, MD,
Assistant Professor,
Yale School of Medicine,
Section of Emergency Medicine,
Department of Surgery,
Attending Physician,
Medical Director,
Department of Emergency Services,
Yale-New Haven Hospital, Conn
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