What is aplasia cutis?
Aplasia cutis (sometimes called ‘aplasia cutis congenita’) is a condition where a newborn child is missing skin from certain areas.
What are the clinical features of aplasia cutis?
In about 70% of cases, aplasia cutis affects the scalp in a single location, but sometimes multiple lesions may appear on other parts of the body. The areas of skin loss vary in size from 0.5 cm to 10 cm.
Superficial aplasia cutis involves only the epidermis (upper layers of skin). The shallow defects usually heal over before the child is born, leaving a scar. Deeper lesions involve the dermis and subcutaneous tissue, and rarely, the skull may be ulcerated.
Membranous aplasia cutis is the term used when there is an underlying flat, white membrane, which overlies a defect in the skull. This form of aplasia cutis can be associated with a neural cranial tube defect (encephalocoele or meningocoele), which can be demonstrated by ultrasound scan showing misplaced brain tissue outside the skull.
How do you get aplasia cutis and who is at risk?
It is not yet fully known why aplasia cutis occurs but the following factors may be involved:
- Genetics: aplasia cutis may be seen in association with other congenital skin defects such as epidermal naevi
- Teratogens (drugs or chemicals causing birth deformities)
- Defect in skin development in the embryo/fetus
- Early rupture of amniotic membranes
- Aplasia cutis affecting the limbs may be associated with the death of a twin fetus (papyreous fetus)
Aplasia cutis is rare with no one particular race or sex more at risk.
What treatments are available for aplasia cutis?
Small areas of aplasia cutis usually heal spontaneously over time. To prevent infection gentle cleaning and bland ointments may be used. If infection occurs antibiotics can be used. Larger lesions may require surgical repair.
What are the complications of aplasia cutis?
Complications of aplasia cutis rarely occur but may include:
- Arterial bleeding
- Secondary infection