Nonsurgical approach to congenital scalp and skull defects

Abstract

The management of congenital scalp and skull defects, as generally advocated, is surgical. The authors report such a case that was treated conservatively. At her 3-year follow-up review, the patient's scalp and skull defects and other associated cutaneous defects were fully reconstituted. Such a nonoperative approach, while rarely reported, emphasizes the natural course that some of these lesions may follow. The literature on aplasia cutis congenita is briefly reviewed.

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

“…[12][13][14][15][16][17][18][19] It is reported that only 15 to 20% of cases of scalp ACC are associated with an underlying bony defect. 2,20 However, the frequency of an underlying osseous defect is higher in larger areas of ACC. 16 In the cases of extensive scalp ACC that we reviewed, 12 of the 16 cases (75%) had skull defects.…”

Aplasia cutis congenita of the scalp

“…A slight female predominance has been reported [11,19]. In approximately 60% of cases the cutaneous defect is limited to the scalp, and in the remaining 40% the lesions may appear scattered over the trunk and/or limbs [6,8,12,17].…”

Surgical Management of Cutis Aplasia with High-Flow Sinus pericranii

“…The major concern with management included preventing hemorrhage from the uncovered veins which were themselves in contact with the sagittal sinus, as well as avoiding the possibility of loss of sagittal sinus collateral drainage going out the scalp veins through the sinus itself. Although these lesions are often managed with dressing changes until epithelialized [1], this approach has the disadvantage of risk of infection and bleeding [2,3], with the additional potential complication of squamous cell carcinoma in the vicinity of the scarred scalp defect. Recent reports have favored primary closure with local flaps and skin grafts when possible [4][5][6][7][8][9].…”