Rare Harlequin Baby Born Without ‘Skin’ In India

In the first of its kind case in India, a ‘Harlequin baby’ girl with almost no external body skin was born to a farmer couple from Wadi, Nagpur on Saturday. The baby had a severe congenital disorder, which is called Harlequin Ichthyosis. Dr. Yash Banait, an obstetrician and gynecologist at the Lata Mangeshkar Medical College & Hospital who was involved in the delivery, said the baby was born blind. Her chances of survival are uncertain.

The Harlequin baby’s ears are missing

The disorder is caused by a genetic mutation. Dr. Yash Banait said the incidence of Harlequin Ichthyosis occurs once in about 300,000 births. The mutation causes the thickening of the stratum corneum of the epidermis. The baby’s entire body is encased in an “armor of thick white plates of skin.” The plates are separated with deep cracks. Her internal organs are visible through the cracks. The Harlequin baby’s toes, palms and fingers haven’t fully developed. Her ears are missing. Her nose is two holes from where she breathes. And her eyes are nothing more than two reddish swabs. Due to the cracked white plates, the bacteria and other contaminants could easily enter her body, posing a serious risk of infection. Doctors said the baby has not developed any breathing problems.

Skin grafting not possible

She has been kept under observation as constant care is required to keep her skin moisturized and protected. Doctors will undertake a 2D Echo investigation to see if there are any cardiac deformities or anomalies. Since there is no skin on the body, skin grafting is out of the question. Dr. Banait said the disorder could be diagnosed in the uterus by morphological analysis of amniotic fluid or by way of fetal skin biopsy. There have been only a few such recorded cases in the history of medical sciences since 1750. The first recorded Harlequin baby was born in April 1750 in South Carolina, USA. The longest surviving Harlequin child was Shaheen in Pakistan, who was born in 1984 and her last medical records are from 2008. Dr. Banait said all they can do is try to keep the baby alive.