A neonate is born encased in a tight, shiny, parchment-like membrane that cracks and fissures on flexion. The membrane peels off in the first few weeks of life, and the subsequent course determines the underlying ichthyosis type. What is this neonatal presentation called, and the most common transient ultimate outcome?

• A Erythroderma neonatorum — resolves completely
• B Harlequin ichthyosis — resolves after peeling
• C Collodion baby — most commonly evolves into lamellar ichthyosis or non-bullous congenital ichthyosiform erythroderma (NBCIE) ✓
• D Epidermolytic ichthyosis — due to KRT1/KRT10 mutation

Explanation

Collodion baby describes the neonatal presentation of a tight, shiny, translucent membrane that restricts movement and is associated with multiple underlying ichthyosis types. After the collodion membrane sheds (1–4 weeks), approximately 80% evolve into specific autosomal recessive congenital ichthyosis (ARCI) — most commonly lamellar ichthyosis (LI) or non-bullous congenital ichthyosiform erythroderma (NBCIE); about 10% self-heal (self-healing collodion baby). Harlequin ichthyosis is the most severe form with thick armour-like plates at birth — distinct from the collodion membrane presentation.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.