According to
Crocker either after the removal of the vernix caseosa, which may
be thick, or as the skin dries it is noticeably red, smooth,
shiny, and in the more severe cases covered with actual plates.
In the harlequin fetus the whole surface of the body is thickly
covered with fatty epidermic plates, about 1/16 inch in
thickness, which are broken up by horizontal and vertical
fissures, and arranged transversely to the surface of the body
like a loosely-built stone wall. After birth these fissures may
extend down into the corium, and on movement produce much pain.
The skin is so stiff and contracted that the eyes cannot be
completely opened or shut, the lips are too stiff to permit of
sucking, and are often inverted; the nose and ears are atrophied,
the toes are contracted and cramped, and, if not born dead, the
child soon dies from starvation and loss of heat. When the
disease is less severe the child may survive some time. Crocker
had a patient, a male child one month old, who survived three
months. Hallopeau and Elliot also report similar cases.
Contagious follicular keratosis is an extremely rare affection in
which there are peculiar, spine-like outgrowths, consisting in
exudations of the mouths of the sebaceous glands.
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