Vernix Caseosa-like hyperkeratosic plaques in a French Canadian infant

A male infant was born at 34 weeks’ gestation with generalized hyperkeratotic plaques on the limbs along with extensive areas of vernix caseosa–like changes on the head and trunk.

Prenatal and Birth Histories
32-year-old gravida 1, para 1 woman with a normal fetal survey

Pregnancy was complicated by mild polyhydramnios; premature rupture of membranes occurred at 32 weeks’ gestation

First child of nonconsanguineous parents of French Canadian ancestry

Estimated gestational age was 34 weeks

Spontaneous vaginal delivery of male infant following unstoppable preterm labor; prophylactic antibiotics were started when the membranes ruptured 2 weeks earlier; Apgar scores were 7 and 8 at 1 and 5 minutes, respectively; no resuscitation required

Birthweight 2.415 kg (50%), birth head circumference 32.5 cm (90%), birth length 44 cm (50%)

Presentation (Day of Birth)
At birth, striking skin changes were noted in the form of generalized edematous spongy hyperkeratotic plaques on the limbs along with extensive areas of vernix caseosa–like changes on the head and trunk (Fig 1). The amniotic fluid appeared thickened because of the presence of skin debris. The infant did not have any respiratory distress. The infant was placed in an incubator with 60% to 70% humidity.