A Rare Case of Scalp Aplasia Cutis Congenita in a Zimbabwean Child
International Journal of Neurosurgery
Volume 2, Issue 2, December 2018, Pages: 35-38
Received: Oct. 23, 2018; Accepted: Nov. 8, 2018; Published: Dec. 4, 2018
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Brighton Valentine Nyamapfene, Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe
Tafadzwa Moreen Dube, Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe
Killion Madondoro, Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe
Aaron Musara, Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe
Kazadi Kaluile Kalangu, Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe
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Skull and scalp defects can be a challenge in the pediatric population. They predispose to meningitis and at times catastrophic exsanguination. Aplasia Cutis Congenita is a very rare condition resulting in a variable degree of absence of epidermis and dermis. It can be associated with skull defects especially the parietal vertex. We report a case managed at our hospital of a 2 week old Zimbabwean baby with a scalp and bi-parietal bone defect present at birth. He had no other congenital anomalies. Our case was managed by rotational pedicled flap to cover the skull defect. Various methods to close the skull defects have been highlighted in literature. These may include either split skin graft or full thickness graft especially if the pericranium is viable for nutritional support. Subgaleal scoring with flap advancement can also be employed by making longitudinal incisions perpendicular to the direction of advancement. Rotational flaps are especially useful in parieto-occipital lesions like our case. Patient factors for example size of defect, location and associated skull defects determine the optimal option to be used. Aplasia Cutis Congenita is therefore a rare condition which needs a multimodal approach. Lesions above 2 cm in greatest diameter and associated skull defects should have early surgery to avoid complications like infections and hemorrhage.
Aplasia Cutis Congenita, Skull Defect, Scalp Reconstruction
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Brighton Valentine Nyamapfene, Tafadzwa Moreen Dube, Killion Madondoro, Aaron Musara, Kazadi Kaluile Kalangu, A Rare Case of Scalp Aplasia Cutis Congenita in a Zimbabwean Child, International Journal of Neurosurgery. Vol. 2, No. 2, 2018, pp. 35-38. doi: 10.11648/j.ijn.20180202.14
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This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Alexandros, Blionas & Giakoumettis, Dimitrios & Elias, Antoniades & Evangelos, Drosos & Andreas, Mitsios & Sotirios, Plakas & Georgios, Sfakianos & Marios, ThemistocleousS. (2017). Aplasia cutis congenita: Two case reports and discussion of the literature. Surgical Neurology International. 8. 273. 10.4103/sni.sni_188_17.
Kalb RE, Grossman ME. The association of aplasia cutis congenita with therapy of maternal thyroid disease. Pediatr Dermatol 1986; 3: 327-30.
Humphrey, S. R., Hu, X., Adamson, K., Schaus, A., Jensen, J. N., & Drolet, B. (2017). A practical approach to the evaluation and treatment of an infant with aplasia cutis congenita. Journal of Perinatology, 38(2), 110–117. doi:10.1038/jp.2017.142.
Tincopa-Wong OW. Aplasia cuits congénita: lo que se conoce en el presente. Dermatol Peru. 2012; 22: 89-110.
Mava Y, Yakubu AM. Aplasia cutis congenita in a Nigerian Child: A case report. Niger J Paediatr 2017; 44 (1):32.
Campbell W. Case of congenital ulcer on the cranium of a fetus. Edinburgh J Med Sci 1826; 2: 82.
Zhou J, Zheng L, Tao W. Systemic aplasia cutis congenita: a case report and review of the literature. Pathol Res Pract. 2010; 206: 504-7.
Magliah T. Alghamdi F. Aplasia Cutis Congenita: A Case Report. Case Rep Dermatol 2018; 10: 182–186.
Jelin AC, Glenn OA, Strachowski L, Vargas JE. Membranous aplasia cutis congenita: A recognizable lesion on prenatal sonography. J Ultrasound Med 2009; 28: 1393-
Gerber M, de Veciano M, Towers CV, Devore GR. Aplasia cutis congenita: a rare cause of elevated alpha- fetoprotein levels. Am J Obstet Gynecol 1995; 172 (3): 1040-1.
Garcia-Romero MT, Narvóez-Rosales V, Hojyo-Tomoka MT. Bullous aplasia cutis congenita: case report and review of the literature. Indian J Dermatol. 2011 May; 56(3): 337–8.
Brzezinski P, Pinteala T, Chiriac AE, Foia L, Chiriac A. Aplasia cutis congenita of the scalp—what are the steps to be followed? Case report and review of the literature. An Bras Dermatol. 2015 Jan-Feb; 90(1): 100–3.
Sekhon V. Aplasia Cutis Congenita of Scalp and Back: A Rare Entity. Ann Clin Case Rep. 2017; 2: 1367.
Martinez-Regueira S, Vazquez-Lopez ME, Somoza-Rubio C, Morales-Redondo R, Gonzalez-Gay MA. Aplasia cutis congenita in a defined population from northwest Spain. Pediatr Dermatol. 2006; 23:528-32.
Maillet-Declerck M, Vinchon M, Guerreschi P, Pasquesoone L, Dhellemmes P, Duquennoy-Martinot V, et al. Aplasia cutis congenita: review of 29 cases and proposal of a therapeutic strategy. Eur J Pediatr Surg. 2013; 23: 89-93.
Fincher EF, Gladstone HB. Dual transposition flaps for the reconstruction of large scalp defects. J Am Acad Dermatol. 2009; 60: 985-9.
Yang JY, Yang WG. Large scalp and skull defect in aplasia cutis congenita. Br J Plast Surg. 2000; 53: 619-22.
Chung KH, Kim TK, Cho BC, Jeon SW, Chung HY. Surgical treatment of aplasia cutis congenita with acellular dermal graft and cultured epithelial autograft. Dermatol Surg. 2009; 35: 546-9.
Yang JY, Yang WG. Large scalp and skull defect in aplasia cutis congenita. Br J Plast Surg 2000; 53: 619-22.
Browning JC. Aplasia cutis congenita: Approach to evaluation and management. Dermatol Ther 2013; 26: 439-44.
Moros Pena M, Labay Matias M, Valle Sanchez F, Valero Adan T, Martin-Calama Valero J, Munoz Albillos M. Aplasia cutis congenita in a newborn: Etiopathogenic review and diagnostic approach] An Esp Pediatr. 2000; 52: 453-6.
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