Question

A child is born covered with a thick membranous coat. What is the most likely diagnosis?

• A. Lamellar ichthyosis
• B. X-linked ichthyosis
• C. Ichthyosis vulgaris
• D. Ichthyosis acquisita

Hint:

The newborn wrapped in a shiny taut membrane has a name: collodion baby.

Answer 1

The Correct Option is A

Step 1: A newborn encased in a thick, shiny, taut membrane is described as a collodion baby.
Step 2: The collodion membrane is the classic neonatal presentation of lamellar ichthyosis (autosomal recessive congenital ichthyosis), where a defective skin barrier cannot retain moisture and the skin forms dull brown-black scales.
Why not the others: X-linked ichthyosis (steroid sulfatase deficiency) shows large dark scales mainly on the neck and limbs in boys, not a collodion membrane at birth. Ichthyosis vulgaris is the commonest form but presents later in childhood with fine flaky scaling and hyperlinear palms, not a membrane. Ichthyosis acquisita is an acquired form in adults linked to malignancy or systemic disease, so it is not a birth presentation.
Ref: Arvind Arora Skin 6e p.203.