International Journal of Neurosurgery

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A Rare Case of Scalp Aplasia Cutis Congenita in a Zimbabwean Child

Received: 23 October 2018    Accepted: 08 November 2018    Published: 04 December 2018
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Abstract

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.

DOI 10.11648/j.ijn.20180202.14
Published in International Journal of Neurosurgery (Volume 2, Issue 2, December 2018)
Page(s) 35-38
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Aplasia Cutis Congenita, Skull Defect, Scalp Reconstruction

References
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[2] Kalb RE, Grossman ME. The association of aplasia cutis congenita with therapy of maternal thyroid disease. Pediatr Dermatol 1986; 3: 327-30.
[3] 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.
[4] Tincopa-Wong OW. Aplasia cuits congénita: lo que se conoce en el presente. Dermatol Peru. 2012; 22: 89-110.
[5] Mava Y, Yakubu AM. Aplasia cutis congenita in a Nigerian Child: A case report. Niger J Paediatr 2017; 44 (1):32.
[6] Campbell W. Case of congenital ulcer on the cranium of a fetus. Edinburgh J Med Sci 1826; 2: 82.
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[8] Magliah T. Alghamdi F. Aplasia Cutis Congenita: A Case Report. Case Rep Dermatol 2018; 10: 182–186.
[9] Jelin AC, Glenn OA, Strachowski L, Vargas JE. Membranous aplasia cutis congenita: A recognizable lesion on prenatal sonography. J Ultrasound Med 2009; 28: 1393-
[10] 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.
[11] 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.
[12] 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.
[13] Sekhon V. Aplasia Cutis Congenita of Scalp and Back: A Rare Entity. Ann Clin Case Rep. 2017; 2: 1367.
[14] 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.
[15] 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.
[16] Fincher EF, Gladstone HB. Dual transposition flaps for the reconstruction of large scalp defects. J Am Acad Dermatol. 2009; 60: 985-9.
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Author Information
  • Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe

  • Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe

  • Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe

  • Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe

  • Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe

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  • APA Style

    Brighton Valentine Nyamapfene, Tafadzwa Moreen Dube, Killion Madondoro, Aaron Musara, Kazadi Kaluile Kalangu. (2018). A Rare Case of Scalp Aplasia Cutis Congenita in a Zimbabwean Child. International Journal of Neurosurgery, 2(2), 35-38. https://doi.org/10.11648/j.ijn.20180202.14

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    ACS Style

    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. Int. J. Neurosurg. 2018, 2(2), 35-38. doi: 10.11648/j.ijn.20180202.14

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    AMA Style

    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. Int J Neurosurg. 2018;2(2):35-38. doi: 10.11648/j.ijn.20180202.14

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  • @article{10.11648/j.ijn.20180202.14,
      author = {Brighton Valentine Nyamapfene and Tafadzwa Moreen Dube and Killion Madondoro and Aaron Musara and Kazadi Kaluile Kalangu},
      title = {A Rare Case of Scalp Aplasia Cutis Congenita in a Zimbabwean Child},
      journal = {International Journal of Neurosurgery},
      volume = {2},
      number = {2},
      pages = {35-38},
      doi = {10.11648/j.ijn.20180202.14},
      url = {https://doi.org/10.11648/j.ijn.20180202.14},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijn.20180202.14},
      abstract = {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.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - A Rare Case of Scalp Aplasia Cutis Congenita in a Zimbabwean Child
    AU  - Brighton Valentine Nyamapfene
    AU  - Tafadzwa Moreen Dube
    AU  - Killion Madondoro
    AU  - Aaron Musara
    AU  - Kazadi Kaluile Kalangu
    Y1  - 2018/12/04
    PY  - 2018
    N1  - https://doi.org/10.11648/j.ijn.20180202.14
    DO  - 10.11648/j.ijn.20180202.14
    T2  - International Journal of Neurosurgery
    JF  - International Journal of Neurosurgery
    JO  - International Journal of Neurosurgery
    SP  - 35
    EP  - 38
    PB  - Science Publishing Group
    SN  - 2640-1959
    UR  - https://doi.org/10.11648/j.ijn.20180202.14
    AB  - 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.
    VL  - 2
    IS  - 2
    ER  - 

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