A new born with an encasement of shiny, tight inelastic scale, resembling oiled parchment is designated as having collodion membrane, which is subsequently shed. The condition is usually a manifestation of congenital ichthyosiform Erythroderma or lamellar icthyosis. Infrequently, an affected infant has normal skin after the membrane is shed. There is presence of ectropion, flattening of ears and nose and fixation of lip in an O shaped configuation. The hair may be absent or may perforate the horny covering.

The collodion membrane is composed of greatly thickened stratum corneium that has been saturated with water. As the water content evaporates in extrauterine life, large fissures appear in the membrane and the membrane is shed, revealing red skin underneath.

The presence of collodion membrane doesn’t necessarily predict that the baby will develop ichthyosis and spontaneous healing may occur. Skin biopsy of collodion membrane is usually not diagnostic. Most collodion babies do have a form of ichthyosis and majority of them develop features of lamellar ichthyosis, bullous ichthyosis, X-linked ichthyosis, Netherton’s syndrome or Gauchers disease.

Complications include cutaneous infection, aspiration pneumonia, hypothermia or hypernatremic dehydration (from excess transcutaneous fluid loss as a result of increased skin permeability). The outcome is uncertain and accurate prognostication impossible with subsequent development of ichthyosis. Treatment initially consists of high fluid intake to avoid dehydration and transepidermal fluid loss and use of heated humidified incubator and emulsifying ointment and retinoids.