PT - JOURNAL ARTICLE AU - Sultan Al-Khenaizan AU - Luluah Al-Mubarak TI - Scalp roof tiles. AID - 10.15537/smj.2021.42.4.20200757 DP - 2021 Apr 01 TA - Saudi Medical Journal PG - 454--456 VI - 42 IP - 4 4099 - http://smj.org.sa/content/42/4/454.short 4100 - http://smj.org.sa/content/42/4/454.full SO - Saudi Med J2021 Apr 01; 42 AB - Clinical Presentation A 2-month-old baby boy, of full-term spontaneous vaginal delivery, presented to the dermatology outpatient clinic with generalized erythroderma, which had been noted since birth. Family history was positive for similar disease in his eldest sister, who died at 6 months of age without a diagnosis. On examination, the patient looked ill with generalized erythroderma, yet there were no signs of ectropion, eclabium, or deformed ears. Diffuse scalp scaling was observed with interlocking tessellation scales over the scalp (Figure 1). Hair microscopy showed in Figure 2. All laboratory results were normal.