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Erythroderma, palmoplantar keratoderma and profound failure to thrive in an infant

M R Judge1, J P Shield, A Cant

  • 1Department of Dermatology, Hospitals for Sick Children, London, U.K.

Insights

A 3-month-old infant experienced severe skin issues, growth failure, and diarrhea. Despite infections, no metabolic or immune cause was found, highlighting a potential unknown condition.

Area of Science:

  • Pediatrics
  • Dermatology
  • Genetics

Background:

  • Severe congenital skin conditions can present with complex systemic manifestations.
  • Early-onset erythroderma and hyperkeratosis may indicate rare genetic or metabolic disorders.

Observation:

  • A female infant developed severe erythroderma and palmoplantar hyperkeratosis at 3 months.
  • The infant subsequently exhibited extreme growth failure and intermittent diarrhea.
  • The clinical course was complicated by recurrent life-threatening infections.

Findings:

  • Comprehensive investigations ruled out known metabolic and immune abnormalities.
  • No recognized underlying cause was identified despite extensive diagnostic workup.
  • The infant's presentation suggests a potentially novel or extremely rare syndromic condition.

Implications:

  • This case underscores the importance of considering undiagnosed conditions in infants with severe dermatological and systemic symptoms.
  • Further research may be needed to identify the etiology of such presentations.
  • Highlights the diagnostic challenges in rare pediatric diseases.

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