Multiple fetal abnormalities due to the maternal use of vitamin A congeners in the treatment of recalcitrant severe acne during pregnancy. Birth defects are similar to those in Di George syndrome and include craniofacial and central nervous system anomalies with dysmorphic facial features, learning problems, cortical blindness, facial nerve paralysis, microtia, metopic synostosis, microphthalmia, and oculomotor paralysis. Associated abnormalities may include cardiovascular, thymic, spinal, urinary, and other defects.