Aplasia cutis congenita
Other Names for this Disease
- Aplasia cutis congenita nonsyndromic
- Congenital defect of skull and scalp
- Scalp defect congenital
Your QuestionMy son was born with aplasia cutis congenita. He is now one year old and the spot on his head is about 4 inches long and 1/2 inch wide. As his head grows, the lesion continues to get bigger. His dermatologist has prescribed a skin cream to keep it moist, but my son continues to scratch it open daily. My son's doctor says that there is nothing that can be done until he is a teenager when a portion of the membrane can be removed and his scalp can be stitched together. I can't see waiting that long without a better recommendation. What treatment options are available?
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Local therapy includes gentle cleansing and the application of bland ointment or silver sulfadiazine ointment to keep the area moist. Antibiotics may be utilized if overt signs of infection are noted. In many cases, other treatment is not necessary because the erosions and the ulcerations almost always heal on their own. Recently, a variety of specialized dressing materials have been developed and used.
Surgical repair is not usually indicated if the defect is small. Recovery is generally uneventful, with gradual epithelialization and formation of a hairless, atrophic scar over several weeks. Small underlying bony defects usually close spontaneously during the first year of life. Surgical repair of large or multiple scalp defects may require excision with primary closure, if feasible, or the use of tissue expanders and rotation of a flap to fill the defect. On occasion, skin and bone grafts may also be required.
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- Joseph G. Morelli. Chapter 647 - Cutaneous Defects. In: Robert M. Kleigman. Nelson Textbook of Pediatrics, 18th edition. Philadelphia, PA: Saunders Elsevier; 2007;
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