Do the skin folds like the Michelin man exist in the real world?
A five-day-old baby boy was brought to the outpatient department with complaints of generalized skin folds. The baby was a product of a non-consanguineous marriage of an Iraqi couple. The folds hadn’t regressed since birth.
The Prenatal period remained unremarkable, and the delivery was uneventful too. The mother was not compliant with her prenatal care. There was no history of similar complaints in either of the parents or their families.
Baby was 2.8 kgs at birth, and his length was 50 cm.
On examination, multiple, bilaterally symmetrical, deep skin folds on the trunk, upper and lower extremities were noticed. Periorbital pitting edema was also present.
The rest of the examination and review of the systems were normal. No other cutaneous lesions were found on the examination. An abdominal examination revealed no organomegaly.
The abdominopelvic ultrasound was also normal.
A diagnosis of Michelin tire baby syndrome (MTBS) was made.
The infant’s parents refused to proceed with the histopathologic examination of the skin, so it was decided to schedule frequent visits to monitor the progress of the skin folds.
During the visits in the next few days, the periorbital edema had reduced, but there was no change in the skin folds.
Michelin tire baby syndrome (MTBS) is a rare disorder that has been named after the mascot of a French tire manufacturer, the Michelin man. The disease is characterized clinically by multiple, symmetric, ring-like, circumferential lesions on the trunk, extremities, and the neck. It could be also known as Kunze–Riehm syndrome.
Usually, the patients are asymptomatic, and in a few cases, the lesions resolve spontaneously too. However, various congenital anomalies are associated with MTBS; therefore, it is imperative to examine for other physical signs and a karyotype to help rule out the chromosomal abnormalities and manage the anomalies associated with it. Appropriate referrals to neurologists, ophthalmologists, cardiologists, plastic surgeons, and otolaryngologists are essential to evaluate the patient thoroughly.
Besides, there is no treatment for MTBS per se. Counselling, reassurance, and observation remain the mainstay of management.
References:
Ramphul K, Mejias S G, Ramphul-Sicharam Y (February 24, 2018) A Rare Case of Michelin Tire Baby Syndrome in a Newborn. Cureus 10(2): e2222. DOI:10.7759/cureus.2222
Metta AK, Ramachandra S, Manupati S. Familial Michelin tire baby syndrome. Indian J Dermatol. 2012;57(1):74-76. doi:10.4103/0019-5154.92690
