The collodion baby is a descriptive term for the infant who is born encased in a tight shiny membrane that resembles plastic wrap. The collodion baby is not a disease entity but is the first expression of some forms of ichthyosis.
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.
A consult with a pediatric dermatologist will be necessary to determine which form of ichthyosis is present, if any. (Contact FIRST for a referral to a dermatologist familiar with ichthyosis.)
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