A 8-month-old female baby presented with cushingoid facies, with large skin folds involving the extremities and trunk since birth (Fig. 1). The child was born to healthy parents in a non-consanguineous marriage. The child weighed 8 kgs, was exclusively breast fed and developmentally normal and had no dysmorhic features. There was no history of similar complaints in other family members. Serum cortisol levels were normal. No abnormality was detected on abdominopelvic sonography.Skin biopsy revealed normal histology.

Fig. 1 Michelin tyre baby with skin folds over trunk.

Michelin tyre baby syndrome is a rare benign genodermatosis resulting in multiple, symmetric skin folds since birth. This was first described by Ross in 1969, deriving its name from resemblance of the skin folds to the mascot of a French tire company. The skin folds are predominantly present on the extremities and trunk rarely on the palms and soles. Multiple congenital anomalies have been associated including low set ears, congenital heart defects, cleft palate and undescended testis. The syndrome may be familial. Skin biopsy may be normal. However there are biopsy reports suggesting diffuse lipomatous nevus in underlying dermis or smooth muscle hamartoma. Scarring instead of increased adipocytes have also been reported. The condition is benign and the skin folds gradually disappear. Differential diagnosis includes congenital amniotic bands; however these are usually solitary and limited to limbs. Beare Stevensons cutis gyrate syndrome is another syndrome characterized by dermatomegaly which is limited to scalp, forehead, face and neck.