Aplasia cutis

What is aplasia cutis?

Aplasia cutis (sometimes called ‘aplasia cutis congenita’) is a condition where a newborn child is missing skin from certain areas. In about 70% of cases it is a single lesion on the scalp, but sometimes multiple lesions may appear on other parts of the body. They vary in size from 0.5cm to 10cm.

Lesions that involve only the epidermis (upper layers of skin) are shallow and usually heal over with scarring before the child is born. A deeper lesion involving the dermis, subcutaneous tissue, or 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. It 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.

Aplasia cutis

How do you get it and who is at risk?

It is not yet fully known why aplasia cutis occurs but the following factors may be involved:

• Genetics
• 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)

It is a rare condition with no one particular race or sex more at risk.

What treatments are available?

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?

Complications rarely occur but may include:

• Arterial bleeding
• Secondary infection