Twin Neonates With Bart’s Syndrome

Diagnosis, Management, and Outcome of Bart's Syndrome Observed in a Sub-Saharan African Country (Senegal, Dakar): 2 Case Reports

Introduction

Bart's syndrome is an uncommon inherited congenital disorder associating congenital cutaneous aplasia of the extremities and inherited epidermolysis bullosa. Bilateral and symmetrical involvement of the limbs is exceptionally described on black skin. In most cases, the diagnosis is clinical; however, the management remains very difficult and the extended forms are a real therapeutic challenge. We report 2 cases of Bart's syndrome observed in a sub-Saharan African country (Senegal, Dakar).

Case Presentation

It was about 2 premature female and male newborns. On physical examination, the girl presented with a total absence of skin on the limbs, associated with cutaneous detachment of the trunk representing a detached and detachable skin surface of 46%; the boy underwent a total absence of skin of more than 50% of the skin surface. The diagnosis of Bart's syndrome was set based on the typical clinical aspect. The blood count and CRP were normal for the girl whereas it revealed some disorders for the boy. The 2 newborns were urgently admitted to an incubator, and the intensive care was started with hyperhydration, anti-staphylococcal prophylaxis, and daily dermatological care with antiseptic baths and fatty dressings.

Conclusion

Bart's syndrome is an uncommon genodermatosis characterized by a clinical triad associating congenital cutaneous aplasia of the extremities, inherited epidermolysis bullosa suspected in the presence of bubbles, and areas of cutaneous fragility and nail deformity. All types of which can be associated with this syndrome. The easy clinical diagnosis but the difficult management encumber the vital prognosis of our cases.

Aplasia Cutis Congenita of the Lower Limb: A Case Report

Aplasia cutis congenita type VI is a genetic disorder that presents with congenital skin absence, blistering, and nail abnormalities. We present the case of a male newborn who presented with an absence of skin in the entire left leg and the lower part of the left thigh. On the second day of life, he had new skin lesions that started to appear over the fingernail beds, nasal bridge, thighs, and buttocks. There were no other associated anomalies such as pyloric atresia, renal abnormalities, or ureteral stenosis. A diagnosis of Bart's syndrome was made based on clinical diagnosis and previous presentation in the family. The patient developed sepsis and osteomyelitis of the lower limb and eventually died.