NYMC Faculty Publications

Extremely Preterm Infant With Persistent Peeling Skin: X-Linked Ichthyosis Imitates Prematurity

Author Type(s)

Faculty

Journal Title

Case Reports in Perinatal Medicine

Document Type

Article

Publication Date

8-10-2021

Department

Pediatrics

Second Department

Health Behavior and Community Health

Abstract

Objectives

X-linked ichthyosis (XLI) is a genetic disorder caused by a deficiency in steroid sulfatase, an enzyme which catalyzes a reaction in estrone synthesis. The disorder primarily manifests as dry, scaly skin which may be difficult to diagnose in extremely preterm infants, as the dermatological features may be falsely attributed to a normal variant of skin for this population.

Case presentation

In this case report, we describe a male with XLI, born at 24 weeks gestation, who had persistent dry, flaky and hyperpigmented skin. This case is notable for the age of diagnosis in an extremely premature infant; day of life 105. In addition, this infant experienced out of proportion bronchopulmonary symptoms that we postulate may be linked to the steroid sulfatase deficiency, as estrogen is a mediator of surfactant production.

Conclusions

This report underscores the need to potentially evaluate persistent dry, flaky skin in the preterm infant, as XLI may also impact long term neurodevelopmental outcomes.

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