Harlequin Infant Born to a Varicella Infected Mother: A Case Report

Meyyappa Devan Rajagopal1, Pampa Ch Toi, Nishad Plakkal

  • 11Senior resident, Department of Pathology, JIPMER, Puducherry, India.

Insights

Harlequin ichthyosis, a severe genetic skin disorder, affects 1 in a million newborns. This case highlights a rare instance in a non-consanguineous family, noting maternal chickenpox during pregnancy.

Area of Science:

  • Genetics
  • Dermatology
  • Neonatology

Background:

  • Harlequin ichthyosis is a rare, severe congenital ichthyosis with a distinct phenotype.
  • It occurs in approximately 1 in 1 million births, with over 100 cases reported.
  • The condition results from mutations in the ABCA12 gene, crucial for lipid transport and stratum corneum development.

Observation:

  • This article presents a case of a harlequin baby born to non-consanguineous parents.
  • The mother had a history of chickenpox during the first trimester of pregnancy.
  • The infant exhibited the characteristic severe physical presentation of harlequin ichthyosis.

Findings:

  • The case underscores the genetic basis of harlequin ichthyosis, linked to ABCA12 gene mutations.
  • Management typically involves supportive care and retinoid derivatives.
  • The prognosis remains poor, with most affected infants succumbing during the neonatal period.

Implications:

  • This case contributes to the limited literature on harlequin ichthyosis, particularly regarding potential environmental factors like maternal infections.
  • It emphasizes the importance of genetic counseling and early diagnosis in affected families.
  • Further research may explore the interplay between genetic predisposition and potential teratogenic exposures in congenital ichthyosis.

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