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Published on: December 31, 2015
Development of a disease severity score for newborns with collodion membrane
Gustavo A Rubio-Gomez1, Miriam Weinstein1, Elena Pope1
1Section of Dermatology, Hospital for Sick Children, and University of Toronto, Toronto, Ontario, Canada.
Background:
Collodion membrane in the neonate may be the initial presentation of a number of different conditions. There is a lack of data correlating the extent of clinical involvement to the underlying disease and prognosis.
Objective:
We sought to identify features predictive of the final outcome and complications in a cohort of patients with collodion membrane, using a disease severity score.
Methods:
This was a retrospective cohort study of newborns with collodion membrane at a tertiary care institution over a period of 31 years. We designed and applied a 0- to 15-point severity score and correlated the results with the final diagnoses and complications. Data on demographics, membrane shedding, and treatment were collected.
Results:
We identified 29 cases. Congenital ichthyosiform erythroderma and lamellar ichthyosis were the most common final diagnoses with 7 of 29 cases (24%) each; 3 patients were given the diagnosis of a syndromic ichthyosis. The classic nonsyndromic ichthyoses had higher average score results (7.33) than the syndromic ichthyoses (2.0) and other presentations (4.0), (P = .0097). Patients with major complications had higher, but nonsignificant, average severity scores (P = .64).
Limitations:
The retrospective design and small number of patients with a syndromic ichthyosis are limitations.
Conclusions:
Prospective studies are required to validate the proposed disease severity score.
