A 40 days old male infant was admitted for cutaneous lesions and poor weight gain. The infant’s parents complain poor feeding and vomiting. He was delivered at term by vaginal delivery after a normal pregnancy. The child was born at 38-week gestational age with a birth body weight of 1700 g, a birth length of 47 cm and a head circumference of 32.5 cm. No resuscitation was required after birth.The only drug used during pregnancy was multivitamin. Body weight was 1900 g. The distal phalanges and nails of both feet were hypoplastic. The fingers of hands were normal. In examination of skin, generalized cutis marmorata was seen. Dilated veins were seen over trunk and head. The patient was formula fed. Abdominal sonogram was negative for hypertrophic pyloric stenosis. Liver and renal function test was normal. Serum electrolyte and arterial blood gases were normal. Echocardiogram was normal. Regular formula was substituted with hydrolyzed formula. Vomiting subsides, but poor feeding and poor weight gain continued. Body weight at 2 months age was 2200 g. Ophthalmologic examination revealed left eye glaucoma. The doctors diagnosed the case as Adams-Oliver syndrome. Adams-Oliver syndrome (AOS) is characterized by the combination of congenital scalp defects (aplasia cutis congenita) and terminal transverse limb defects of variable severity. The exact pathogenesis of AOS is unknown. Vascular impairment during embryogenesis has been proposed as a possible mechanism. Doctors have you encountered any such rare cases in your practice? Case and images taken from- https://www.pagepress.org/journals/index.php/pr/article/view/6517/6072#figures

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CHILDRENS AND INFUNTS. APPETITE LOST. VOMITTING. BLOOD VESSELS DISTENDED. PULSE IS THE REMEDY DR.

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Informative Doctor

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Iforrmative@Dr. Pushker Mehra

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