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Top-Accessed Article: Skin Markers of Occult Spinal Dysraphism in Children FREE

Julie V. Schaffer, MD
Arch Dermatol. 2012;148(8):934. doi:10.1001/archdermatol.2012.728.
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Guggisberg D, Hadj-Rabia S, Viney C, et al. Skin markers of occult spinal dysraphism in children: a review of 54 cases. Arch Dermatol. 2004;140(9):1109-1115.

“Marker” skin lesions on the posterior midline are evident in approximately 80% of individuals with occult spinal dysraphism.1 In a retrospective study of 54 children with congenital midline lumbosacral skin lesions, Guggisberg and colleagues found that 61% (11 of 18) of patients with 2 or more types of cutaneous findings in this location had occult spinal dysraphism compared with 8% (3 of 36) of those with a single skin finding (P < .001). Although small numbers of patients precluded risk assessment for specific types of isolated lumbosacral skin lesions, the authors concluded that certain solitary lesions (eg, a lipoma or a dermal sinus) were “high risk.” More recently, a prospective study showed an approximately 35% risk of spinal anomalies in patients with an isolated lumbosacral infantile hemangioma larger than 2.5 cm in diameter,2 adding this to the high-risk category. Both Guggisberg and coauthors and Drolet et al2 emphasized the need for spinal magnetic resonance imaging in individuals with multiple or high-risk isolated lumbosacral skin lesions, noting only approximately 50% sensitivity for spinal ultrasonography (even if performed at <4-6 months of age).

From October 2010 to August 2011, this article was viewed 2916 times on the Archives of Dermatology Web site.

ARTICLE INFORMATION

Contact Dr Schaffer at the Department of Dermatology, New York University School of Medicine, 560 First Ave, Rm H-100, New York, NY 10016 (julie.schaffer@nyumc.org).

REFERENCES

Schropp C, Sörensen N, Collmann H, Krauss J. Cutaneous lesions in occult spinal dysraphism—correlation with intraspinal findings.  Childs Nerv Syst. 2006;22(2):125-131
PubMed   |  Link to Article
Drolet BA, Chamlin SL, Garzon MC,  et al.  Prospective study of spinal anomalies in children with infantile hemangiomas of the lumbosacral skin.  J Pediatr. 2010;157(5):789-794
PubMed   |  Link to Article

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References

Schropp C, Sörensen N, Collmann H, Krauss J. Cutaneous lesions in occult spinal dysraphism—correlation with intraspinal findings.  Childs Nerv Syst. 2006;22(2):125-131
PubMed   |  Link to Article
Drolet BA, Chamlin SL, Garzon MC,  et al.  Prospective study of spinal anomalies in children with infantile hemangiomas of the lumbosacral skin.  J Pediatr. 2010;157(5):789-794
PubMed   |  Link to Article

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