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Elmoqaddem H, Ayyad A, Messaoudi S, Amrani R. A Case Report on Aplasia Cutis Congenita: Insights Into the Impact of Maternal Carbimazole Use. Cureus 2024; 16:e68663. [PMID: 39233728 PMCID: PMC11374110 DOI: 10.7759/cureus.68663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2024] [Indexed: 09/06/2024] Open
Abstract
Congenital aplasia cutis (CAC) is a rare neonatal condition characterized by the absence of skin at birth, often associated with diverse underlying conditions. We report the case of a newborn male admitted on the second day of life with a skin defect on the anterior abdominal wall and a lesion on the left thigh. The mother was treated with carbimazole for hyperthyroidism. Notably, there were no similar cases in the family history. The patient showed favorable progress and normal development following a successful dermo-epidermal allograft. Particular attention was given to managing the risk of infection and ensuring optimal healing through tailored wound care protocols. This case underscores the complexity of CAC, highlighting the importance of early diagnosis, multidisciplinary care, and ongoing research to understand better and effectively treat this rare condition.
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Affiliation(s)
- Hajar Elmoqaddem
- Mother and Child Health Laboratory, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR
- Department of Neonatology and Neonatal Resuscitation, Mohammed VI University Hospital, Oujda, MAR
| | - Anass Ayyad
- Department of Neonatology and Neonatal Resuscitation, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR
| | - Sahar Messaoudi
- Mother and Child Health Laboratory, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR
| | - Rim Amrani
- Mother and Child Health Laboratory, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Oujda, MAR
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2
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She QY, Zhu HL, Liu ZR, Huang WN. Membranous aplasia cutis congenita: A rare case report highlighting clinical presentation, genetic insights, and the need for comprehensive evaluation. Heliyon 2024; 10:e33742. [PMID: 39027568 PMCID: PMC11255487 DOI: 10.1016/j.heliyon.2024.e33742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/25/2024] [Accepted: 06/26/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Membranous aplasia cutis congenita (MACC) is the most common clinical subtype of aplasia cutis congenita (ACC). It is typified by a localized skin lesion devoid of hair and features a membranous surface. While most MACC individuals do not present with concurrent abnormalities, it can sometimes co-occur with additional physical anomalies and various malformation syndromes. Moreover, the underlying causes of MACC remain elusive. Case presentation We describe a case of a 6-month-old female infant diagnosed with MACC. The patient presented with a midline skin lesion on the occipital scalp, characterized by a glistening surface and a hair collar sign. Dermoscopic examination revealed specific features, including translucency, telangiectasia, and hypertrichosis. The infant had a history of patent foramen ovale, and further examination uncovered an asymptomatic ventricular septal defect. Whole exome sequencing revealed 20 gene variants relevant to the clinical phenotype of the patient, suggesting a possible association with MACC. Conclusion MACC is a rare and underreported condition, primarily diagnosed based on its distinctive clinical features. It is imperative to emphasize the significance of thorough evaluations in MACC patients, encompassing developmental, cardiac, neurological, and genetic assessments to facilitate early detection and the exclusion of potentially life-threatening comorbidities. Importantly, genetic characterization, as demonstrated in this case, contributes to our understanding of MACC's etiology and highlights the need for further research in this field.
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Affiliation(s)
- Qiu-Yun She
- Department of Dermatology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Hui-ling Zhu
- Department of Dermatology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Zhong-Rong Liu
- Department of Dermatology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Wei-Ning Huang
- Department of Dermatology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
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3
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Rose MD. An Extensive Case of Aplasia Cutis Congenita. Cureus 2024; 16:e63215. [PMID: 39070430 PMCID: PMC11281886 DOI: 10.7759/cureus.63215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/30/2024] Open
Abstract
Aplasia cutis congenita (ACC) is a rare connective tissue disorder that affects the epidermis, dermis, and subcutaneous tissue. Lesions can be small and benign or, in some cases, large and extensive. The lesions can be covered by a thin membrane, and depending on their location, they can make the underlying tissue vulnerable to damage or infection. This case report focuses on a term male infant born with extensive scalp defects and later diagnosed with ACC. The study will discuss the pathophysiology and classification of this disorder. This will provide clinicians with a recommended approach for the initial management of infants diagnosed with ACC in their practice.
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Affiliation(s)
- Matthew D Rose
- Paediatric Intensive Care, Leeds General Infirmary, Leeds, GBR
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4
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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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5
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Yang XF, Shi SW, Chen K. Case report: Recombinant human epidermal growth factor gel plus kangfuxin solution in the treatment of aplasia cutis congenita in a case with Adams-Oliver syndrome. Front Surg 2023; 9:1072021. [PMID: 36713669 PMCID: PMC9874222 DOI: 10.3389/fsurg.2022.1072021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/05/2022] [Indexed: 01/12/2023] Open
Abstract
Background Aplasia cutis congenita is a congenital disorder with the absence of skin, muscle and(or) bone. It usually affects the scalp. The presence of a large scalp defect can be potentially serious when complicated with hemorrhage and infection. Early healing of this condition is beneficial to improve the prognosis of infants. Study case A full-term newborn male was born with a round-shaped defect at the vertex of the scalp and skull (dimensions, 8 cm × 9 cm). The infant had a large deletion encompassing the 15.1 region of chromosome 15, including the DLL4 gene. Genetic testing was positive for Adams-Oliver syndrome (AOS). After two months of recombinant human epidermal growth factor gel combined with kangfuxin solution therapy, the skin defects of the scalp healed remarkably. The infant had regular follow-up appointments. At the age of 5 months, the defect became smaller, hairless, and showed good granulation tissue. At 2 years of age, the child's Gesell Developmental Schedules was 70. Conclusion Recombinant human epidermal growth factor gel combined with kangfuxin solution was a successful conservative treatment for an infant with a large scalp defect accompanied by AOS.
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Affiliation(s)
- Xiu-Fang Yang
- Department of Neonatology, Zhongshan Hospital Affiliated to Sun Yat-Sen University, Zhongshan, China,Correspondence: Xiu-Fang Yang
| | - Shang-Wen Shi
- Department of Neonatology, Zhongshan Hospital Affiliated to Sun Yat-Sen University, Zhongshan, China
| | - Kang Chen
- Molecular Inspection Center, Zhongshan Hospital Affiliated to Sun Yat-Sen University, Zhongshan, China
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6
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Garcia C, Wortsman X, Bazaes-Nuñez D, Pelizzari M, Gonzalez S, Cossio ML, De Barbieri F. Skin sonography in children: a review. Pediatr Radiol 2022; 52:1687-1705. [PMID: 35821441 DOI: 10.1007/s00247-022-05434-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/29/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022]
Abstract
Skin lesions are not uncommon in children, and most of them are benign. However, they can be a matter of concern. Although in most cases the diagnosis can be suspected based on clinical history and physical examination, in some cases clinical findings are nonspecific. High-frequency color Doppler US is a noninvasive technique that can play a relevant role in these cases and give important anatomical information for final clinical management. US can be helpful to avoid unnecessary surgery, plan a surgical excision and avoid advanced imaging studies such as MRI and CT, which have a lower resolution for the skin. Different lesions can look similar on US, and clinical correlation is always important. The purpose of this article is to show a variety of skin lesions that occur in children, emphasizing clinical-sonographic correlation, and to familiarize pediatric radiologists with the US technique and sonographic appearance of common skin lesions in children.
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Affiliation(s)
- Cristian Garcia
- Department of Radiology, Pontificia Universidad Católica de Chile, 367 Marcoleta, 8330024, Santiago, Chile.
| | - Ximena Wortsman
- Department of Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Diego Bazaes-Nuñez
- Department of Radiology, Pontificia Universidad Católica de Chile, 367 Marcoleta, 8330024, Santiago, Chile
| | - Mario Pelizzari
- Department of Radiology, Universidad Católica de Córdoba, Ciudad de Córdoba, República Argentina.,Section of Pediatric Radiology, Instituto Oulton, Ciudad de Córdoba, República Argentina
| | - Sergio Gonzalez
- Department of Pathology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maria-Laura Cossio
- Department of Dermatology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Florencia De Barbieri
- Department of Radiology, Pontificia Universidad Católica de Chile, 367 Marcoleta, 8330024, Santiago, Chile
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7
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Baroudi I, Alakhras O, Douri T, Alkhani N. Adams–Oliver syndrome, intestinal obstruction and heart defects: a case series of aplasia cutis congenita. Oxf Med Case Reports 2022; 2022:omab141. [PMID: 35083055 PMCID: PMC8787629 DOI: 10.1093/omcr/omab141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 11/05/2021] [Accepted: 12/04/2021] [Indexed: 11/12/2022] Open
Abstract
Aplasia cutis congenita (ACC) is a rare congenital defect described by the absence of skin and occasionally subcutaneous tissues or bone. The management of ACC varies depending on the lesion size, location and associated abnormalities. Small lesions often heal spontaneously, whereas larger lesions are significant and usually associated with additional anomalies in other organs. This paper reports three cases, which describe large lesions of ACC, presented with other abnormalities (Adams–Oliver syndrome, intestinal obstruction and heart defect). Particular attention should be paid to the patient with large lesions of ACC to investigate more congenital anomalies.
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Affiliation(s)
- Ihsan Baroudi
- Faculty of medicine, University of Hama, Hama, Syria
| | - Ola Alakhras
- Faculty of medicine, University of Hama, Hama, Syria
| | - Thaer Douri
- Department of Dermatology, Al Assad Medical Center, Hama, Syria
| | - Nedal Alkhani
- Department of Pediatrics, Al Assad Medical Center, Hama, Syria
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8
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Yang XF, Shi SW, Ye Y, Chen K. A successful case of preimplantation genetic testing for monogenic disorder for aplasia cutis congenita. Front Pediatr 2022; 10:1005272. [PMID: 36458141 PMCID: PMC9705585 DOI: 10.3389/fped.2022.1005272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Aplasia cutis congenita (ACC), also called congenital cutaneous hypoplasia, is a serious disease in newborns. Children with ACC often die due to wound infections and bleeding. How the incidence of ACC can be reduced is a question that needs to be solved urgently. CASE REPORT We reported a mother who had delivered two children with ACC, both of whom were diagnosed with ACC type VI, skin defects, limb deformities, and congenital heart malformations. One infant died a few days after birth, and another died in utero in the second trimester. Genetic testing in both children showed a heterozygous mutation in the ITGB4 gene [17q25 exon 8, c. 794 dupC, (p. Ala266fs) and exon 15, c. 1860G > A]. The mother later successfully gave birth to a healthy baby using Preimplantation Genetic Testing for Monogenic disorders(PGD-M). CONCLUSION The PGD-M technique is highly valuable in reducing the incidence of ACC and improving the prognoses of newborns.
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Affiliation(s)
- Xiu-Fang Yang
- Department of Neonatology, Zhongshan Hospital Affiliated to Sun Yat-Sen University, Zhongshan, China
| | - Shang-Wen Shi
- Department of Neonatology, Zhongshan Hospital Affiliated to Sun Yat-Sen University, Zhongshan, China
| | - Yun Ye
- Reproductive Medicine Center, Zhongshan Hospital Affiliated to Sun Yat-Sen University, Zhongshan, China
| | - Kang Chen
- Molecular Inspection Center, Zhongshan Hospital Affiliated to Sun Yat-Sen University, Zhongshan, China
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9
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Prasad GR, Rao JVS, Fatima F, Anjum F. Congenital Pyloric Atresia: Experience with a Series of 11 Cases and Collective Review. J Indian Assoc Pediatr Surg 2021; 26:416-420. [PMID: 34912139 PMCID: PMC8637985 DOI: 10.4103/jiaps.jiaps_295_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/20/2020] [Accepted: 11/27/2020] [Indexed: 11/15/2022] Open
Abstract
Introduction: Pyloric atresia is a rare cause of congenital gastric outlet obstruction. It is often associated with epidermolysis bullosa (EB). Rarity and experience with 11 cases are the reason for this publication. Aims and Objectives: The aim and objective of this study is to present our experience of 11 cases of congenital pyloric atresia and correlate with available literature. Materials and Methods: This was retrospective cohort of 11 cases correlative comparative study. Data of all the 11 cases from 1982 to 2019 were collected, reviewed, and analyzed. The parameters studied included age, gender, antenatal diagnosis, postnatal diagnosis, preoperative management, intraoperative findings, postoperative course outcome, associated anomalies, and any genetic studies if done. All these parameters were compared with published data. Results: There were 11 cases in the present series with six boys and five girls. Most of them presented at varying periods from birth to day 1 of life. Discussion: Congenital pyloric atresia may be isolated or associated with EB. Three varieties of pyloric atresia were described. Association with EB increases the mortality. Conclusions: Review and analysis of 11 cases of pyloric atresia compared with published literature is being reported.
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Affiliation(s)
| | - J V Subba Rao
- Department of Anesthesia, DCMS, Hyderabad, Telangana, India
| | - Firdous Fatima
- Department of General Surgery, DCMS, Hyderabad, Telangana, India
| | - Fariha Anjum
- Department of General Surgery, DCMS, Hyderabad, Telangana, India
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10
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Kalavar M, Echegaray JJ, Ashkenazy N, McKeown C, Berrocal AM. Choroidal calcifications in two cases of aplasia cutis congenita and oculoectodermal syndrome. Ophthalmic Genet 2021; 43:258-261. [PMID: 34895016 DOI: 10.1080/13816810.2021.1998552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe choroidal calcifications as an ophthalmic feature in aplasia cutis congenita (ACC) with oculoectodermal syndrome (OES). OBSERVATIONS Two cases of ACC/OES with characteristic echographic evidence of choroidal calcifications are described. CONCLUSIONS AND IMPORTANCE The ophthalmic manifestations of ACC/OES may be expanded to include choroidal calcifications. The presence of a choroidal calcification with B-scan ultrasound in a case suspicious for ACC/OES may facilitate a more timely diagnosis and inform future follow-up regimens to monitor ophthalmic and systemic manifestations of this disease.
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Affiliation(s)
- Meghana Kalavar
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jose J Echegaray
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Noy Ashkenazy
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Craig McKeown
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Audina M Berrocal
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA
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11
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Effendi RMRA, Nuraeni L, Diana IA, Gondokaryono SP, Gunawan H, Dwiyana RF. Extensive Type V Aplasia Cutis Congenita Without Fetus Papyraceus or Placental Infarction: A Rare Case. Clin Cosmet Investig Dermatol 2021; 14:1413-1418. [PMID: 34675576 PMCID: PMC8502006 DOI: 10.2147/ccid.s330160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 09/16/2021] [Indexed: 11/23/2022]
Abstract
Aplasia cutis congenita (ACC) is a congenital disorder characterized by the absence of epidermis, dermis, and sometimes subcutaneous tissue and bone. There are nine types of ACC based on the number and location of the lesions as well as the presence or absence of associated deformities, with type I ACC being the most common. Type V affects the trunk with a characteristic pattern resembling the "H" letter of the alphabet, generally accompanied by fetus papyraceus (death of one of the twin fetuses) or placental infarction. Type V ACC without fetus papyraceus and placental infarction is a rare case. We reported a case of type V ACC in a 3-day-old baby girl, with clinical manifestation of extensive ulcers on the scalp, back, buttocks, and both lower extremities, in an "H"-shaped pattern, with history of placenta accreta, but no fetus papyraceus or placental infarction was found. The patient received dialkyl carbamoyl chloride hydrophobic swab with hydrogel (Sorbact® gel dressing-BSN Medical) and hydrocolloid wound dressing with good response, as indicated by the wounds becoming dried up, leaving an atrophic scar. Complete epithelialization was achieved in 72 days. The cause of type V ACC remains not completely understood. The diagnosis of ACC can be established based on clinical manifestations. Further examination is required if extracutaneous involvement is suspected. Early identification of the etiology of the lesions and appropriate investigation and treatment, including conservative wound management, are needed so that aplastic lesions can heal successfully, although cosmetic repair may be required at a later stage.
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Affiliation(s)
| | - Lita Nuraeni
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Inne Arline Diana
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Srie Prihianti Gondokaryono
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Hendra Gunawan
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Reiva Farah Dwiyana
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
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12
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Cammarata-Scalisi F, Diociaiuti A, de Guerrero B, Willoughby CE, Callea M. Membranous aplasia cutis congenita in trisomy 18. Ital J Pediatr 2020; 46:120. [PMID: 32854736 PMCID: PMC7450555 DOI: 10.1186/s13052-020-00885-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 08/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aplasia cutis congenita (ACC) is a rare congenital condition characterized by the absence of skin layers and sometimes other underlying structures, in a localized or widespread area. The exact etiopathogenesis is not yet completely understood. Membranous ACC (MACC) also described as bullous or cystic ACC is a clinical subtype of ACC, covered with a membranous or glistening surface, and appears as a flat scar. There are less than 20 cases reported in the literature. It has been proposed an abortive form of a defective closure of the neural tube. On the other hand, the trisomy 18 is a chromosomal abnormality characterized by a broad clinical spectrum and the presence of defective closure of the neural tube. CASE PRESENTATION We report on an 18-months-old Venezuelan boy, who presented on the parietal scalp a distinctive localized MACC appearing as an oval lesion covered with a membranous surface, characterized by the absence of hairs and the presence of a sharp hair collar. The karyotype in peripheral blood was 47,XY,+ 18. CONCLUSIONS This is the second case report of ACC in trisomy 18 and reinforces the interpretation of a non-fortuitous association as well as of a defective closure of the neural tube as pathogenetic mechanism. The case highlights the importance of examining for dermatological alterations such as ACC in cases of chromosomopathy.
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Affiliation(s)
| | - Andrea Diociaiuti
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | | | - Michele Callea
- Unit of Dentistry, Bambino Gesù Children Hospital and Research Institute, Rome, Italy.
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13
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Mukhtar-Yola M, Mshelia L, Mairami AB, Otuneye AT, Yawe ET, Igoche P, Audu LI. Aplasia cutis congenita: a report of two cases from National Hospital Abuja, Nigeria and review of the literature. Pan Afr Med J 2020; 36:291. [PMID: 33117485 PMCID: PMC7572678 DOI: 10.11604/pamj.2020.36.291.24523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 06/30/2020] [Indexed: 02/05/2023] Open
Abstract
Aplasia cutis congenita is a rare congenital abnormality first described in 1767 by cordon. It mostly appears as a solitary lesion involving various layers of the skin and sometimes the bone on the scalp, limbs or abdomen. Genetics, environmental and exogenous causes have been implicated as potential causes. Only about 500 cases have been reported globally as of 2013. Two cases of Aplasia Cutis Congenita (ACC) who presented with scalp and bone defects at birth are reported, one in a syndromic child delivered to a consanguineous family, with associated cardiac, skin and nail anomalies (likely Adams Oliver syndrome) and the other as an isolated scalp lesion. Both were large defects managed conservatively by a multidisciplinary team. The challenges of investigating and managing such complex scalp anomalies in sub-Saharan Africa are highlighted.
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Affiliation(s)
| | - Lauretta Mshelia
- Department of Paediatrics, National Hospital Abuja, Abuja, Nigeria
| | | | | | | | - Patricia Igoche
- Department of Paediatrics, National Hospital Abuja, Abuja, Nigeria
| | - Lamidi Isah Audu
- Department of Paediatrics, National Hospital Abuja, Abuja, Nigeria
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14
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Whalen M. Multiple Aplasia Cutis Congenita Lesions of the Scalp: A Case Study. Neonatal Netw 2020; 39:83-91. [PMID: 32317338 DOI: 10.1891/0730-0832.39.2.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2019] [Indexed: 06/11/2023]
Abstract
Aplasia cutis congenita (ACC) is a rare condition that presents at birth as an absence of skin that does not usually involve underlying structures. Occurring in 3/10,000 live births, ACC is evenly distributed between males and females; the risk of ACC increases to 7 percent in consanguineous marriages. Up to 86 percent of lesions are found on the scalp in the midline vertex position. Lesions can also be found on the trunk and limbs, as with Adams-Oliver syndrome or accompanying epidermolysis bullosa. ACC is associated with chromosomal abnormalities and 35-50 percent of the time with trisomy 13 (Patau syndrome). This case study presents an infant with multiple ACC lesions of the scalp. The pathophysiology, treatment, potential long-term complications, and nursing considerations are discussed.
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15
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Shin D, Kim YH, Song HG, Hong JW. Serially expanded flap use to treat large hairless scalp lesions. Arch Craniofac Surg 2020; 20:408-411. [PMID: 31914499 PMCID: PMC6949505 DOI: 10.7181/acfs.2019.00500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 10/10/2019] [Indexed: 12/02/2022] Open
Abstract
Hairless scalp areas can occur due to trauma, tumors, or congenital disease. This aesthetically unpleasing condition can lead to psychosocial distress, and thin skin flaps may be prone to scarring. Treating the hairless scalp by simple excision is challenging because of skin tension. Tissue expanders are a good option for hairless scalp resurfacing. However, a single expansion may be inadequate to cover the entire defect. This report describes good results obtained using a serial resurfacing method involving re-expansion of the flap with a tissue expander to treat two patients with large lesions: one due to aplasia cutis congenital and another who underwent dermatofibrosarcoma protuberance resection. The results suggest that scalp resurfacing by serial tissue expansion using a tissue expander can be used for extensive lesions.
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Affiliation(s)
- Dongwoo Shin
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Hun Kim
- Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | | | - Jong Won Hong
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea
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