Bilateral Skin Lesions

Aplasia cutis congenita {ACC} is a rare condition characterized by congenital absence of skin and sometimes subcutaneous tissue as well. Incidence of ACC is 2.8 per 10,000 newborns. {1} Usually the defect is found in scalp where it is often solitary. {2} Non scalp lesions are rare, may involve the trunk and, or extremities and are usually bilaterally symmetrical. These non scalp lesions are sometimes associated with twin pregnancy in which the other twin dies in utero and is lost as fetus papyraceous {3} as in our case. Possible reason being vascular disruption caused by release of some prothrombotic materials by the dead fetus. {3} Management of ACC is mainly conservative with proper antiseptic dressings. Larger lesions may sometimes require surgical intervention with skin grafts, local skin flaps. {4}

References :

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;23:528–532. Crowe MA. Aplasia Cutis Congenita. Available at website: emedicine.medscape.comperrticle, 1110134-overview. Accessed on 15th February 2015 Cambiaghi S, Schiera A, Tasin L, Gelmetti C. Aplasia cutis congenita in surviving co-twins: four unrelated cases. Pediatr Dermatol. 2001;18: 511-515 Ahcan U, Janezic T. Management of aplasia cutis congenita in a non-scalp location. Br J Plast Surg. 2002; 55: 530–532