Skin Markers of Occult Spinal Dysraphism in Children

Guggisberg, D.; Hadj‐Rabia, Smail; Viney, C.; Bodemer, Christine; Brunelle, Françis; Zérah, Michel; Pierre-Kahn, Alain; Prost, Y. De; Hamel‐Teillac, Dominique

doi:10.1001/archderm.140.9.1109

Cited by 223 publications

(165 citation statements)

References 45 publications

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“…Ben-Sira et al used ultrasound to screen 254 neonates with midline skin stigmata 1 and found no pathological findings in any of the 109 cases with simple dimples. Other studies have also reported normal ultrasound results in most patients with sacrococcygeal dimples 6,7,12,15 and suggested that ultrasound screening is not necessary for infants with low-risk lesions, such as simple dimples. This finding contrasts with our study, in which 16.7% of the patients with simple dimples (both deep and shallow) had FTF, and 7% also had a low conus.…”

Section: Discussionmentioning

confidence: 95%

Intraspinal lesions associated with sacrococcygeal dimples

Harada¹,

Nishiyama²,

Yoshimura³

et al. 2014

PED

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Object Sacrococcygeal dimples in the gluteal fold, also known as coccygeal pits, are observed in 2%–4% of newborns. Sacrococcygeal dimples are not generally considered to be associated with a significant risk of intraspinal anomalies and therefore are not thought to require further radiographic evaluation. Accordingly, the precise incidence and nature of intraspinal lesions that may be associated with sacrococcygeal dimples is unclear. This study was conducted to determine the incidence of intraspinal lesions in patients with intergluteal dimples. Methods In this study, the authors used MRI to evaluate 103 children who were seen at the Niigata University Medical and Dental Hospital between 2006 and 2011 because of skin abnormalities in the lumbosacral region. Of these children, 14 were excluded as having a subcutaneous fatty mass, and 5 were excluded because the dimples were above the gluteal fold or did not end at the coccyx. The remaining 84 patients were classified according to whether the bottom of the dimple was visible (shallow) or not (deep). The authors also retrospectively examined other skin abnormalities and coexisting anomalies. Results The mean age at the time of MRI evaluation was 11.7 months. Magnetic resonance imaging led to the identification of fibrolipoma of the terminal filum (FTF) in 14 cases (16.7%); 6 of these patients also had a low conus. Classified by depth, there were 58 cases with shallow and 26 with deep dimples. Fibrolipoma of the terminal filum was found in significantly more patients with deep dimples (9 [34.6%]) than in those with shallow dimples (5 [8.6%]). The frequency of other congenital anomalies was significantly higher in patients with FTF-associated dimples (6 [42.9%] of 14) than in those with dimples that were not associated with FTF (9 [12.9%] of 70). Conclusions Fibrolipoma of the terminal filum was identified by MRI in 16.7% of patients with sacrococcygeal dimples. The risk of FTF increased when the dimples were deeply excavated or were accompanied by congenital anomalies. Magnetic resonance imaging should be performed to identify intraspinal lesions when there are high risk factors for intraspinal abnormalities, or when an ultrasound screening suggests intraspinal abnormalities.

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Section: Discussionmentioning

confidence: 95%

Intraspinal lesions associated with sacrococcygeal dimples

Harada¹,

Nishiyama²,

Yoshimura³

et al. 2014

PED

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“…[1] Two or more congenital midline skin lesions are considered as the strongest markers of occult spinal dysraphism. [2] The present case shows that such simple lesions should be taken seriously if they occur simultaneously. On the other hand, Mongolian spots, sacral pits and dimples do not indicate a high risk of occult spinal dysraphism.…”

mentioning

confidence: 61%

Not just a capillary hemangioma

Kanburoğlu

2015

World J Pediatr

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“…2 When these lesions are present in association with a segmental and minimal growth hemangioma, the LUMBAR association may be present [L (lower body hemangioma, lipoma, and other cutaneous defects) U (urogenital anomalies and ulceration) M (myelopathy) B (boney deformities) A (anorectal malformations and arterial anomalies) R (renal anomalies)]. Approximately 30% of these patients will have associated tethered cord, and early diagnosis and treatment is necessary to lessen the risk of permanent neurologic damage [3][4][5] (Fig. 1).…”

Section: Infantile Hemangiomasmentioning

confidence: 99%