Harlequin fetus

ichthyosis congenita gravis

This condition, a severely escalated (and thankfully rare) type of ichthyosis, was once invariably fatal within a few days of birth (if even it lived that long). It is marked by skin so hardened that cracks develop where folds would be seen in a normal baby. The condition was first observed in South Carolina by Reverend Oliver Hart.

"On Thursday, April ye 5, 1750, I went to see a most deplorable object of a child, born the night before of one Mary Evans in "Chas"town. It was surprising to all who beheld it, and I scarcely know how to describe it. The skin was dry and hard and seemed to be cracked in many places, somewhat resembling the scales of a fish. The mouth was large and round and open. It had no external nose, but two holes where the nose should have been. The eyes appeared to be lumps of coagulated blood, turned out, about the bigness of a plum, ghastly to behold. It had no external ears, but holes where the ears should be. The hands and feet appeared to be swollen, were cramped up and felt quite hard. The back part of the head was much open. It made a strange kind of noise, very low, which I cannot describe. It lived about forty-eight hours and was alive when I saw it. "

I do not have a photograph of a harlequin fetus to show you, and am not certain I would do so even had I such a picture. This is my most feared of deformities; it has caused me fits of cold sweat and palsy to view. Even today.

Update here: Ms. Kristy Milland of the Birth Disorder Information Directory was kind enough to send me this link to a case study that includes a fine image of the sort I above did not have. Or so I surmise-- naturally I have not been able to bring myself to look at it head on. Although you're free to do so. Carry on.

Incidentally, this article's citations led me to the case study of a Bangladeshi girl who was rescued from the worst ravages of this condition by timely medical care. Since then, there have been television specials on survivors, but at the time I was not aware any harlequin fetus had made it out of infancy. The article's accompanying photos were understandably difficult for me to face, but I'm glad I forced myself to look. The last one shows a toddler, with chapped skin covered in salve, but otherwise essentially normal. The contrast with the harrowing "before" pictures brought me to open tears.