Birth incidence and outcome of harlequin ichthyosis and collodion membrane in the UK and Ireland: a national 2-year prospective surveillance study

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Abstract
Dear Editor, The ichthyoses are rare disorders characterized by thick, scaly skin. The commonest neonatal type, autosomal recessive congenital ichthyosis (ARCI), is genetically heterogeneous,1 with prognoses ranging from neonatal death to rapid spontaneous resolution. ARCI usually presents as collodion membrane (CM), and rarely harlequin ichthyosis (HI). This common neonatal phenotype and uncertain prognosis present challenges for neonatologists, with a risk of iatrogenic complications from overtreatment. Recommendations for managing HI and CM are generic, based on more severe cases, and include intensive monitoring in a humidified incubator.2 By contrast, the authors’ experience is that babies with uncomplicated CM can be nursed successfully in an open cot with minimal monitoring, facilitating skincare, parental bonding and early discharge from hospital.
Funding Information
  • Great Ormond Street Hospital and Sparks Charity

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