Absent Skin and Butterfly Children: A Sporadic Case of Bart Syndrome

A full-term male infant with a history of in utero exposure to cocaine and alcohol was born with circumferential bilateral lower extremity ulcerations and skin hypoplasia over the same region (Figure). Upon light touch of these lesions, the infant became restless and fussy. A thorough dermatologic physical examination revealed dystrophy of several toenails involved with the ulcerations. Two punch biopsies from distinct areas of the margin of the...