Physical examination showed patient to be small for gestational age and microcephalic. He also had bilateral low-set ears, ectropion, yellowish foul-smelling discharge on the umbilical stump, left undescended testes, with normal neurologic examination. Focused dermatologic examination revealed generalized mild erythema with desquamation, fissures on the inguinal area, shiny and taut skin on knees and scalp with minimal scaling [Figure 1] and [Figure 2]. Hair was wiry, brittle and sparse; it would easily break and fall off once lightly touched [Figure 3].
Figure 1: Patient at 2nd day of life. He has generalized fine scaling with slight erythema
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Figure 2: Closer view of lower extremities which shows the generalized fine scaling with slight erythema. Note skin on knees are shiny and taut, indicating presence of collodion membrane at birth
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Figure 3: Closer view of patient's face which shows generalized fine scaling, wiry and brittle hair, and ectropion
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