A FEMALE infant, the first of dizygotic twins, was born at 32 weeks'
gestation to a gravida 1, 20-year-old mother. One twin was normal but the
other's clinical appearance was striking (Figure 1). The skin was hard, thickened, and split irregularly to
reveal erythematous moist fissures. There was severe ectropion of all 4 eyelids.
The external ears were rudimentary and the mouth showed eclabia causing a
characteristic "fish-mouth" appearance.
Chua CN, Ainsworth J. Ocular Management of Harlequin Syndrome. Arch Ophthalmol. 2001;119(3):454-455. doi:10.1001/archopht.119.3.454