A newborn boy was evaluated shortly after birth for generalized ichthyosis. He was born by spontaneous vaginal delivery to a 39-year-old G5P1A3 carrying a methionine tetrahydrofolate reductase mutation treated with heparin at 38 weeks gestation. Stunted growth of his femurs at 34 weeks noted on sonography complicated his prenatal course. The mother had generalized "dry skin" at birth, which subsequently became limited in distribution, and complained of "scars" involving her arms and legs that were red, scaly, and hairless. She mentioned having persistent hairless patches on her scalp present since birth and denied having focal loss of skin in these areas at birth. She denied problems with vision or hearing. She was short (5'1) but had no scoliosis. She had given birth to a girl with skin findings similar to those of the newborn boy; however she had given the newborn girl for adoption, so she was unsure about subsequent changes in her skin or overall health.
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