Xeroderma Pigmentosum (XP) is a rare autosomal recessive (AR) disease characterized by hypersensitivity of
the skin to ultra violet (UV) radiation, resulting in a high frequency of UV induced skin tumors and progressive neurological
complications at an early age. Through the following case report we emphasize that perioperative management of
xeroderma patients entails meticulous evaluation for neurological abnormalities, shielding the skin from OT (operation
theatre) lights by using protective clothing, sunscreen and UV blocking film as well as avoidance of genotoxic drugs like
volatile anaesthetics and paracetamol. One must be prepared for the possibility of difficult mask ventilation (we used a
mask one size larger), difficult intubation and prolonged effect of muscle relaxants (as in our case) due to skin atrophy,
neoplasia, joint contracture and neuronal dysfunction.