Neonatal erythroderma and collodion baby

Erythroderma in the newborn is rare and can be fatal. Ichthyosis, immunodeficiencies, infections and metabolic disorders are among the most common causes. An overview will be given of the most common causes of congenital (present at birth) and neonatal (developed within 4 weeks postpartum) erythroderma, including the collodion baby. Especially an immunodeficiency or metabolic disorder can be missed, as signs as lymphadenopathy, fever and 'failure to thrive' are absent. An erythrodermic newborn does not have to appear ill. It takes up to 11 months until a definitive diagnosis is made. To prevent complications and death,early and specific are needed. Unfortunately, history, physical examination and histological investigations are not always diagnostic and immunological and genetic research is needed. We have made a national protocol on how to approach the erythrodermic newborn. This is to be found using the following website: www.huidhuis.nl/afdeling/neonataleerythrodermie. The protocol is being tested in a prospective study at moment at the Erasmus MC. Doctors who are confronted by an erythrodermic neonate, are advised to follow this protocol.