Acquired raised bands of infancy: association with amniotic bands

Amniotic band syndrome associated with extremely severe atypical clefts of the orofacial region

Amniotic band syndrome (ABS) is not a commonly seen birth defect; however, it may have the potential to be severe and life-threatening requiring adequate attention. We present a severe case of amniotic band syndrome which encircled the head of the neonate tightly causing severe deformity. In this case report, the amniotic band encircled the head causing a severe bilateral Tessier 7 cleft. To our knowledge, this is the most severe type of ABS reported in the literature thus far.

Level of evidence: Level V, risk / therapeutic study.

Clinical Approach to Linear Hyperpigmentation: A Review Article

Linear hyperpigmentation is an unusual anatomical configuration in clinical dermatology. Owing to its rarity, consensus on the most effective method of classification is lacking. While linear hyperpigmentation generally follows Blaschko's lines, this is not universal. Clinical findings such as adherence to Blaschko's lines, associated morphological findings (including other cutaneous lesions), and systemic manifestations can be used to further characterize and diagnose variants of the disorder. Early detection of any underlying disease is vital, especially in cases with effective management, because the disorder may make it difficult to manage hyperpigmentation. Herein, we introduce a logical clinical diagnostic approach that represents a useful tool for dermatologists to efficiently evaluate patients presenting with linear hyperpigmentation. A simplified systematic and evidence-based approach is useful for this clinical condition owing to the heterogeneous causes and lack of specific diagnostic tools.

Heel-line hyperpigmentation: a variant of sock-line hyperpigmentation after the use of heel-length socks

Two infants developed hyperpigmented curvilinear patches on the posterior heel after wearing heel-length socks. Both of the patient's lesions improved after discontinuing the use of the heel-length socks. Hyperpigmented patches called sock-line or mitten-line hyperpigmentation have been reported at sites of tight elastic bands from socks or mittens in infants on the calves and wrists. Recognizing this clinical entity is important to differentiate it from other causes of linear lesions such as child abuse or amniotic band syndrome.

An unusual amniotic rupture sequence with thoracoabdominal restricting band, low-set posterior hairline, and trapezius contracture

Amniotic rupture sequence is associated with defects of variable severity and at different sites. Analysis of the literature reveals difficulties in the classification, which, in addition to uncertainties surrounding its causes, make diagnosis of unusual presentations rather difficult. We present an unusual case of a thoracoabdominal restrictive band from the umbilicus to a low-set posterior hairline with severe trapezius contracture, sternoclavicular dislocation, and no associated craniofacial or limb abnormalities. Amnion rupture sequence with adhesion band seems to be the most probable cause of this rare combination of anomalies.

Mitten-line hyperpigmentation: a reactive process analogous to sock-line hyperpigmentation

A 3-month-old girl presented with a 6-week history of a curvilinear hyperpigmented patch on the left wrist, which began within a day of using a tight mitten. Mitten-line hyperpigmentation is analogous to the recently described condition known as infantile "sock-line hyperpigmentation," or more generally "sock-line bands." Distinguishing this benign condition from child abuse, amniotic band syndrome, and acquired raised bands of infancy is important but sometimes challenging.

The use of a topical antihistamine in the treatment of raised linear bands of infancy

Raised linear bands of infancy is a newly recognized but rarely reported entity whose etiology remains unknown. Some cases have been associated with dermatographism and it has been postulated that the bands may be related to an increase in collagen deposition and fibrosis from increased mast cell mediators. This is the first reported case of raised linear bands responding to treatment with a topical antihistamine.

Persistent linear bands in infancy acquired after local pressure: a consequence of mast cell activation?

A 10-month-old girl with marked symptomatic dermographism presented with linear bands at the sock line noted to have developed following an episode of localized urticaria and angioedema at the sock line. We speculate that release of mast cell mediators associated with the dermographism may have triggered the development of the linear bands.