Skin lesions in occult spinal dysraphism: A case series

Abstract

BACKGROUND: Occult spinal dysraphism (OSD) represents a spectrum of congenital anomalies that are characterized by skin-covered lesions without exposed neural tissue, which can cause rostrocaudal traction on the spinal cord. Prophylactic surgery has a high likelihood of changing the natural history in which a gradual loss of function may be replaced by clinical stability. Detection of OSD in infants is difficult because an abnormal neurological examination is often not apparent until the child becomes ambulatory, or even later. Cutaneous signs are often the initial markers of congenital spine abnormalities and investigation of skin lesions in these patients may lead to earlier diagnosis of OSD.This study was conducted to investigate the frequency and type of cutaneous stigmata in different forms of OSD. METHODS: In a prospective study, 39 patients with OSD were referred to our hospital from August 23, 2001 to March 20, 2010. RESULTS: A total of 39 patients, 15 (38.5%) males and 24 (61.5%) females, with the age range of 4 months to 41 years (mean=12.8 y) were included in this study. Skin stigmata were present in 66.66% of patients and most frequent findings were hypertrichosis followed by lipoma. CONCLUSIONS: The discovery of a midline skin lesion in an otherwise well, asymptomatic neonate or child often prompts a search for OSD using imaging modalities. Cutaneous markers in a high percentage accompany spinal malformations. They can aid the clinician in further diagnostic and therapeutic work. The knowledge of these skin lesions can guide the clinician to underlying spinal pathology. Copyright ط¢آ© 2013 by Lippincott Williams & Wilkins.