Background: 

Olmsted syndrome is a rare and complex skin disorder affecting 46 (published) infants as of 2012. The infants affected in this case were born premature at 28 weeks' gestation. Infants affected by this syndrome demonstrate numerous plaques on several specific areas of the skin. Common treatments include exfoliation in addition to psoriasis treatments. The extremely fragile nature of the premature infants' skin complicates treatment modalities.

Clinical Findings: 

The progression of the infants' dermatologic findings and plaque formation is discussed in this case study.

Primary Diagnosis: 

The primary diagnosis of Olmsted syndrome was made with the assistance of a multidisciplinary team to work through several differential diagnoses presenting with severe forms of palmoplantar keratoderma.

Interventions: 

The management of skin plaques in twin premature infants is presented in this case study. An evidence-based approach, utilizing the model of family-centered care, is presented with multidisciplinary involvement and an outline of the specific plan of care for the extensive skin care regimen used.

Outcomes: 

An interdisciplinary skin care regimen was created to provide consistency in transition from hospital to home. Using a consistent approach, the plaques were able to be softened and many removed. Continual maintenance is required to manage continual buildup of skin plaques.

Practice Recommendations: 

Premature infants are at increased risk for infection due to the immaturity of their skin. The complexity of their skin complicates the ability to recognize and care for rare skin disorders. This case study illuminates the practicality of a consistent and evidence-based approach to a complex and rare skin disorder.

中文翻译：

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奥姆斯特德综合症：早产双胞胎护理管理病例报告

背景： 

奥姆斯特德综合征是一种罕见且复杂的皮肤病，截至 2012 年，已有 46 名（已发表）婴儿受到影响。该病例中受影响的婴儿在妊娠 28 周时早产。受这种综合征影响的婴儿在皮肤的几个特定区域会出现大量斑块。除了牛皮癣治疗之外，常见的治疗方法还包括去角质。早产儿皮肤极其脆弱，使得治疗方式变得复杂。

临床结果： 

本案例研究讨论了婴儿皮肤病学表现和斑块形成的进展。

初步诊断： 

奥姆斯特德综合征的初步诊断是在多学科团队的协助下，通过对严重掌跖角化症的几种鉴别诊断得出的。

干预措施： 

本案例研究介绍了双胞胎早产儿皮肤斑块的处理。提出了一种基于证据的方法，利用以家庭为中心的护理模式，涉及多学科参与，并概述了所使用的广泛皮肤护理方案的具体护理计划。

结果： 

创建了跨学科的皮肤护理方案，以确保从医院到家庭的过渡保持一致。使用一致的方法，斑块能够被软化并且许多斑块被去除。需要持续维护来控制皮肤斑块的持续堆积。

实践建议： 

早产儿由于皮肤不成熟，感染的风险增加。他们皮肤的复杂性使识别和护理罕见皮肤病的能力变得复杂。本案例研究阐明了针对复杂且罕见的皮肤病采用一致且基于证据的方法的实用性。