[Malignant keratoma]. / Kératome malin.

INTRODUCTION: Birth of an Harlequin fetus in an African maternity ward is an exceptional event. There is no question as to the diagnosis, but no treatment is available. CASE REPORT: A female infant was delivered with typical lesions of malignant keratoma. Death occurred 20 hours after birth. DISCUSSION: In countries with adequate intensive care facilities (hydration, acitretine), such infants may occasionally survive with the risk of developing major lamellar ichthyosis which remains a handicap for the rest of life. In Burkina-Faso, such therapeutic facilities are lacking as are means of antenatal diagnosis. The ethical question as to whether or not to attempt survival measures is quite different under these conditions.