Harlequin Ichthyosis in Resource Limited Environments: Practical Strategies to Improve Neonatal Survival

Harlequin ichthyosis is a rare and life-threatening congenital disorder with high neonatal mortality, particularly in settings lacking specialized neonatal intensive care. We report a preterm newborn managed in a rural hospital without modern incubators, continuous monitoring, systemic retinoids at birth, or specialized personnel. Survival was achieved through pragmatic, low-cost interventions including an improvised humidified incubator, intensive topical emollient therapy, basic respiratory support, umbilical venous access for fluid and electrolyte management, and later initiation of oral isotretinoin. This case highlights that essential supportive care and adaptive use of available resources can improve outcomes in resource-limited settings.