1 Division of Medical Genetics, University of South Florida, Tampa, FL
Contemporary pre- and neonatal care has prolonged the survival of newborns with severe genodermatoses, including the harlequin and collodion baby phenotypes.1 This has provided an excellent opportunity for longitudinal observations that have illustrated the nonspecificity of these clinical concepts and the limited number of ways integumentum commune has in responding to varied noxae. In addition, such observations reflect the long-term dynamics of skin changes. The dynamics could lead to a string of sometimes even contradictory morphologic diagnoses. I describe a collodion baby by phenotype, a girl who in time had several different diagnoses.2 Eventually, an 8-year period of reevaluations with several cutaneous biopsies and hair analysis resulted in a diagnosis considered accurate and etiologically sound.
Submitted on January 24, 1990