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      Hoyuelo cutáneo occipital en una recién nacida Translated title: Occipital skin dimple in a new-born girl

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          Abstract

          Resumen El seno dérmico es un defecto congénito de cierre del tubo neural que se produce entre la tercera y la cuarta semana de gestación. Es una variedad de disrafismo que permite una potencial comunicación entre la piel y el sistema nervioso central. Se localiza preferentemente en línea media posterior, desde el occipucio hasta la región lumbosacra; la localización occipital es la segunda más frecuente. La clínica es muy variable, desde pacientes asintomáticos hasta el desarrollo de meningitis o abscesos por comunicación con el sistema nervioso central como primera manifestación clínica. La resonancia magnética es la prueba de imagen diagnóstica más adecuada, ya que permite determinar la extensión de las lesiones y descartar lesiones a otros niveles. Se recomienda exéresis quirúrgica profiláctica total en todos los casos. Presentamos un caso de una recién nacida con un hoyuelo cutáneo en la región occipital visualizado en la primera exploración física.

          Translated abstract

          Abstract The dermal sinus is a congenital neural tube closure defect that occurs between the 3rd -4th week of gestation. It is a variety of dysraphism that allows a potential communication between the skin and the central nervous system. It often is located in the posterior midline, from occipital to lumbosacral region, the occipital location is the second most frequent. The clinic is very variable, from asymptomatic patients to development of meningitis or abscesses due to a communication with the central nervous system as the first clinical manifestation. Magnetic resonance imaging is the most appropriate diagnostic imaging test, it allows to determine the lenght of the fistulous path and rule out injuries at other levels. Total prophylactic surgical excision is recommended in all cases. We present a case of a newborn with a skin dimple in occipital region visualized in the first physical examination.

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          Most cited references5

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          Posterior fossa dermoid cyst with sinus tract and meningitis in a toddler.

          Intracranial dermoid cysts are rare, but can cause recurrent bacterial or aseptic meningitis, abscesses or mass effect. We describe a toddler who manifested an occipital "lump" for 6 months without further evaluation. He presented with lethargy and meningitis. A posterior fossa dermoid cyst with a sinus tract was detected by imaging studies. He underwent prompt surgical excision of the cyst and the sinus, and received a prolonged course of antibiotics, because anaerobes were isolated from the contents of the cyst and blood. His postoperative course was complicated, and required the placement of a lumboperitoneal shunt. A high index of suspicion for the detection of dermoid cysts is required when a congenital midline skin lesion such as a dimple or a scalp swelling is reported. Prophylactic excision is indicated to prevent serious sequelae.
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            Cranial dermal sinus: presentation, complications and management.

            Cranial dermal sinus is a very rare anomaly mostly found in the midline occipital area, presenting with diverse clinical features from asymptomatic dermal sinus to symptomatic situations including meningitis, dermoid tumor or abscess.
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              Spinal dermal sinuses and dermal sinus-like stalks analysis of 14 cases with suggestions for embryologic mechanisms resulting in dermal sinus-like stalks

              Spinal dermal sinuses consist of an epithelium-lined tract extending from the skin towards the spinal cord, often resulting in infections or tethered cord syndrome. Recently, a variant called dermal sinus-like stalk was described as an analogous tract but not containing an epithelium-lined lumen.
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                Author and article information

                Journal
                pap
                Pediatría Atención Primaria
                Rev Pediatr Aten Primaria
                Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )
                1139-7632
                December 2019
                : 21
                : 84
                : 393-396
                Affiliations
                [3] Alcázar de San Juan. Ciudad Real orgnameComplejo Hospitalario La Mancha Centro España
                [4] Alcázar de San Juan. Ciudad Real orgnameHospital General La Mancha Centro orgdiv1Servicio de Ginecología y Obstetricia España
                [2] Alcázar de San Juan. Ciudad Real orgnameHospital General La Mancha Centro orgdiv1Servicio de Pediatría España
                [1] Alcázar de San Juan. Ciudad Real orgnameHospital General La Mancha Centro España
                Article
                S1139-76322019000400012 S1139-7632(19)02108400012
                c843ff58-da25-48bd-8a5d-00c876b684f3

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 5, Pages: 4
                Product

                SciELO Spain

                Categories
                Notas Clínicas

                Spinal dysraphism,Disrafia espinal,Enfermedades de la piel,Espina bífida oculta,Hoyuelo cutáneo,Meningitis,Seno dérmico,Skin diseases,Spina bifida occulta,Skin dimple,Dermal sinus

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