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Song Y, Yang R, Shi Z, Yan J, Hou S, Li X, Zhao X. Large skin defect in Type V aplasia cutis congenita treated with conservative treatment: a case report. BMC Pediatr 2024; 24:314. [PMID: 38714985 PMCID: PMC11075243 DOI: 10.1186/s12887-024-04777-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 04/19/2024] [Indexed: 05/12/2024] Open
Abstract
Aplasia cutis congenita (ACC) is a congenital disorder that can be classified into nine types, with Type I ACC being the most common. Type V ACC associated with fetus papyraceus is a rare subtype of ACC. We report the case of a Type V ACC in a male newborn with extensive abdominal skin defects. The patient received conservative treatment using hydrogel foam and silicone foam dressings. Approximately five weeks later, the patient was discharged when more than 60% of the skin had completed epithelialization. After discharge from West China Second University Hospital, Chengdu , the patient continued to be followed up regularly at the Burns and Plastic Surgery Clinic at local hospital in Gansu. We followed up the child by telephone. After 4 months of follow-up, scar tissue formation was observed in the trunk area. The infant is 2 years and 5 months old now, physical examination did not reveal any organ problems.
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Affiliation(s)
- Yan Song
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, (Sichuan University), Ministry of Education, Chengdu, China
| | - Ru Yang
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, (Sichuan University), Ministry of Education, Chengdu, China
| | - Zeyao Shi
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, (Sichuan University), Ministry of Education, Chengdu, China
| | - Jing Yan
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, (Sichuan University), Ministry of Education, Chengdu, China
| | - Shulin Hou
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, (Sichuan University), Ministry of Education, Chengdu, China
| | - Xiaowen Li
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, (Sichuan University), Ministry of Education, Chengdu, China.
| | - Xiufang Zhao
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China.
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, (Sichuan University), Ministry of Education, Chengdu, China.
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Bouali S, Charfeddine SH, Ghedira K, Mechergui H, Abderrahmen K, Kallel J. Large aplasia cutis congenita of the vertex conservative management. Childs Nerv Syst 2024; 40:285-292. [PMID: 37865964 DOI: 10.1007/s00381-023-06190-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Aplasia cutis congenita (ACC) of the vertex with bone defect is a rare and begnin anomaly that can involve the epidermis, dermis, and subcutaneous tissues of the scalp with significant bone defect Bajpai and Pal (J Pediatr Surg 38(2):e4, 2003). When associated with skull defect, this rare malformation carries the risk of severe complications such as rupture of the superior sagittal sinus or infections. METHODS AND RESULTS We report a case of aplasia cutis congenita of the scalp with skull defect measuring 9 × 10 cm and an exposed sagittal sinus in a newborn. Both conservative and surgical methods have been proposed to treat this condition. In our case, conservative treatment was planned led to complete epithelization and the patient was healing well at 5 years of follow-up. CONCLUSIONS ACC of the vertex with a large scalp defects present a management dilemma Rocha et al. (Clin Case Rep 3(10):841-4, 2015). Based on a review of the literature, we report this case to demonstrate that even for the largest skin and bone defects, an initial conservative approach may allow for complete wound closure without the need for early surgical intervention.
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Affiliation(s)
- Sofiene Bouali
- Department of Neurosurgery, National Institute of Neurology"Mongi Ben Hmida", Tunis Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
| | | | - Khalil Ghedira
- Department of Neurosurgery, National Institute of Neurology"Mongi Ben Hmida", Tunis Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Haifa Mechergui
- Department of Neurosurgery, National Institute of Neurology"Mongi Ben Hmida", Tunis Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Khansa Abderrahmen
- Department of Neurosurgery, National Institute of Neurology"Mongi Ben Hmida", Tunis Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Jalel Kallel
- Department of Neurosurgery, National Institute of Neurology"Mongi Ben Hmida", Tunis Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
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Blionas A, Giakoumettis D, Antoniades E, Drosos E, Mitsios A, Plakas S, Sfakianos G, Themistocleous MS. Aplasia cutis congenita: Two case reports and discussion of the literature. Surg Neurol Int 2017; 8:273. [PMID: 29204308 PMCID: PMC5691551 DOI: 10.4103/sni.sni_188_17] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 08/23/2017] [Indexed: 11/04/2022] Open
Abstract
Background: Aplasia cutis congenita (ACC) is a part of a heterogeneous group of conditions characterized by the congenital absence of epidermis, dermis, and in some cases, subcutaneous tissues or bone usually involving the scalp vertex. There is an estimated incidence of 3 in 10,000 births resulting in a total number of 500 reported cases to date. The lesions may occur on every body surface although localized scalp lesions form the most frequent pattern (70%). Complete aplasia involving bone defects occurs in approximately 20% of cases. ACC can occur as an isolated defect or can be associated with a number of other congenital anomalies such as limb anomalies or embryologic malformations. In patients with large scalp and skull defects, there is increased risk of infection and bleeding along with increased mortality and therefore prompt and effective management is advised. Case Description: We describe two cases of ACC, involving a 4 × 3 cm defect managed conservatively and a larger 10 × 5 cm defect managed surgically with the use of a temporo-occipital scalp flap. Both cases had an excellent outcome. Conclusions: Multiple treatment regimens exist for ACC, but there is no consensus on treatment strategies. Conservative treatment has been described and advocated, but many authors have emphasized the disadvantages of this treatment modality. Decision between conservative and surgical management must be individualized according to lesion size and location.
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Affiliation(s)
- Alexandros Blionas
- Department of Neurosurgery, Asklepieion Hospital of Voula, Voula, Greece
| | - Dimitrios Giakoumettis
- Department of Neurosurgery, University of Athens Medical School, "Evangelismos" General Hospital, Athens, Greece
| | - Elias Antoniades
- Department of Neurosurgery, University of Thessaloniki Medical School, "AHEPA" University Hospital, Thessaloniki, Greece
| | - Evangelos Drosos
- Department of Neurosurgery, University of Athens Medical School, "Evangelismos" General Hospital, Athens, Greece
| | - Andreas Mitsios
- Department of Neurosurgery, Children's Hospital "Agia Sofia", Athens, Greece
| | - Sotirios Plakas
- Department of Neurosurgery, Kings College Hospital NHS Foundation Trust, London, UK
| | - Georgios Sfakianos
- Department of Neurosurgery, Children's Hospital "Agia Sofia", Athens, Greece
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