Aplasia cutis congenita

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Aplasia cutis congenita
Synonyms
Pronounce	N/A
Specialty	N/A
Symptoms	Absence of skin, usually on the scalp
Complications	Infection, bleeding, scarring
Onset	Congenital
Duration
Types	N/A
Causes	Genetic mutation, teratogens
Risks
Diagnosis	Physical examination, imaging
Differential diagnosis	Amniotic band syndrome, epidermolysis bullosa
Prevention
Treatment	Surgical intervention, wound care
Medication	Antibiotics for infection
Prognosis	Generally good with treatment
Frequency	1 in 10,000 births
Deaths	Rare

Alternate names

Aplasia cutis congenita nonsyndromic; Congenital defect of skull and scalp; Scalp defect congenital

Definition

Aplasia cutis congenita is a condition in which there is congenital (present from birth) absence of skin, with or without the absence of underlying structures such as bone.

File:Congenital patch of Hypotrichosis (1).jpg

Epidemiology

Aplasia cutis congenita affects approximately 1 in 10,000 newborns. The incidence of the nonsyndromic form is unknown.

Cause

• There is no one cause for all cases of aplasia cutis congenita.
• The condition is thought to be multifactorial, which means that several factors likely interact to cause the condition. Factors that may contribute include genetic factors; teratogens (exposures during pregnancy that can harm a developing fetus) such as methimazole, carbimazole, misoprostol, and valproic acid; compromised vasculature to the skin; and trauma.
• Some cases may represent an incomplete or unusual form of a neural tube defect.
• Familial cases of aplasia cutis congenita have been reported.

Inheritance

• Most cases of nonsyndromic aplasia cutis congenita are sporadic, which means they occur in people with no history of the disorder in their family.
• When the condition runs in families, Cases that appear to be genetic may be inherited in an autosomal dominant or autosomal recessive manner.

Signs and symptoms

• It most commonly affects the scalp, but any location of the body can be affected.
• While most people with aplasia cutis congenita have no other abnormalities, some people have congenital malformations involving the cardiovascular (heart), gastrointestinal, genitourinary, and central nervous systems.

For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. 80%-99% of people have these symptoms

• Aplasia cutis congenita over the scalp vertex
• Calvarial skull defect(Cranial defect)
• Congenital localized absence of skin
• Spinal dysraphism

30%-79% of people have these symptoms

• Skin ulcer(Open skin sore)

5%-29% of people have these symptoms

• Abnormality of bone mineral density
• Facial palsy(Bell's palsy)
• Finger syndactyly
• Prolonged bleeding time
• Toe syndactyly(Fused toes)

Diagnosis

Molecular Genetics Tests may include:

• Deletion/duplication analysis
• Sequence analysis of the entire coding region

Treatment

• Treatment of aplasia cutis congenita varies depending on the condition of the infant.
• Conservative treatment is preferred.
• Small areas usually heal on their own over time.
• Gentle cleansing and application of bland ointments or silver sulfadiazine can help prevent infection.
• If infection occurs, antibiotics can be used.
• Recently, a variety of specialized dressing materials have been developed and used.
• Larger lesions may require surgery.
• Ultimately, the decision to use medical, surgical, or both forms of therapy depends primarily on the size, depth, and location of the skin defect.

Prognosis

• The long-term outlook (prognosis) for people with aplasia cutis congenita is usually excellent.
• If the condition is associated with other abnormalities or malformations, the prognosis then depends on the nature and severity of the other condition(s).
• Major complications of aplasia cutis congenita are rare, but can include hemorrhage, secondary local infection, meningitis, or sagittal sinus thrombosis.
• Larger affected areas associated with underlying bony defects can cause death due to central nervous system infection, or hemorrhage from the sagittal sinus.
• Complications can also result from associated abnormalities or malformations, when present.

NIH genetic and rare disease info

• NIH info on Aplasia cutis congenita

Aplasia cutis congenita is a rare disease.