Login Register Cart 0
Generic placeholder image

New Emirates Medical Journal

Editor-in-Chief
ISSN (Online): 0250-6882

Back
Journal Home About Journal Editorial Board Current Issue Volumes/Issues
Subscribe
Case Report

Approach in Management of Aplasia Cutis Congenita in a Newborn with Adam Oliver Syndrome

Author(s): Ihab H. El Kadry*, Tarek Koratum and Laila Obaid

Volume 2, Issue 1, 2021

Published on: 18 May, 2020

Page: [42 - 44] Pages: 3

DOI: 10.2174/0250688201999200518121808

open_access

Abstract

Introduction: Aplasia Cutis Congenita (ACC) is a rare congenital disorder characterized by the absence of skin and adjacent tissue that usually affect the scalp. A large scalp defect in ACC with adjacent tissue anomalies is associated with high morbidity and mortality. The management of these lesions can be challenging. The treatment can be either conservative, surgical, or combined.

Case: A full-term newborn girl delivered with a huge scalp defect. The dura mater was exposed but intact and there was no Cerebrospinal Fluid (CSF) leakage. She also had bilateral talipes equinovarus and terminal reduction of multiple toes in the left foot. Genetic testing was positive for Adam Oliver Syndrome. Conservative medical management was initiated at birth and continued until discharge at 4 weeks of age. The patient had a regular follow-up with plastic surgery and neurosurgery teams. At 11 months old, the defect became smaller, hairless with good granulation tissue, but still soft and compressible.

Conclusion: Large scalp midline ACC is a rare, but potentially devastating disease when involved adjacent tissue. The choice of treatment is not straightforward and it is mainly based upon the size, depth, and the risk of pre and post-treatment complications. Conservative management still is an option with very complex ACC.

Keywords: Aplasia cutis congenita, Adams-Oliver syndrome, Neonatal skin disorder, Congenital disorder, Cerebrospinal fluid, Scalp midline.

[1]
Cordon M. Extrait du¨ne lettre au sujet de trois enfants de la meme mere nex avec partie des extremmites denuee de peau. J Med Chir Pharm 1767; 26: 556-7.
[2]
Campbell W. Case of congenital ulcer on the cranium of a fetus. 1826.
[3]
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(6): 528-32.
[http://dx.doi.org/10.1111/j.1525-1470.2006.00303.x] [PMID: 17155992]
[4]
Fröjd V, Maltese G, Kölby L, Tarnow P. Conservative healing of an 11 × 9-cm aplasia cutis congenita of the scalp with bone defect. J Neurol Surg Rep 2014; 75(2): e220-3.
[http://dx.doi.org/10.1055/s-0034-1387195] [PMID: 25485218]
[5]
Dudoignon B, Huber C, Michot C, et al. Expanding the phenotype in Adams-Oliver syndrome correlating with the genotype. Am J Med Genet A 2020; 182(1): 29-37.
[http://dx.doi.org/10.1002/ajmg.a.61364] [PMID: 31654484]
[6]
Bharti G, Groves L, David LR, Sanger C, Argenta LC. Aplasia cutis congenita: Clinical management of a rare congenital anomaly. J Craniofac Surg 2011; 22(1): 159-65.
[http://dx.doi.org/10.1097/SCS.0b013e3181f73937] [PMID: 21187755]
[7]
Burkhead A, Poindexter G, Morrell DS. A case of extensive aplasia cutis congenita with underlying skull defect and central nervous system malformation: Discussion of large skin defects, complications, treatment and outcome. J Perinatol 2009; 29(8): 582-4.
[http://dx.doi.org/10.1038/jp.2008.250] [PMID: 19638992]
[8]
Maillet-Declerck M, Vinchon M, Guerreschi P, et al. Aplasia cutis congenita: review of 29 cases and proposal of a therapeutic strategy. Eur J Pediatr Surg 2013; 23(2): 89-93.
[PMID: 22903250]
[9]
Harvey G, Solanki NS, Anderson PJ, Carney B, Snell BJ. Management of aplasia cutis congenita of the scalp. J Craniofac Surg 2012; 23(6): 1662-4.
[http://dx.doi.org/10.1097/SCS.0b013e31826542de] [PMID: 23147310]
[10]
Betancourth-Alvarenga JE, Vázquez-Rueda F, Vargas-Cruz V, Paredes-Esteban RM, Ayala-Montoro J. Surgical management of aplasia cutis congenita. An Pediatr (Barc) 2015; 83(5): 341-5.
[http://dx.doi.org/10.1016/j.anpedi.2015.02.005] [PMID: 25804551]

Rights & Permissions Print Cite
Article Metrics
9
1
© 2024 Bentham Science Publishers | Privacy Policy