The diagnostic value of skin lesions in split cord malformations.

Split cord malformations (SCMs) are rare congenital anomalies of the spine which are usually diagnosed and treated in early childhood. Asymptomatic patient can appear in adult life without diagnosis. Cutaneous signs are often the initial marker of congenital spine abnormalities, especially SCMs. Although numerous cutaneous lesions have been described that may occur with SCMs including abnormal hair growth, hemangiomas, telengiectasias, pigmentation anomalies, subcutaneous mass lesions, and dermal sinus tracts, there is no study demonstrating a correlation between skin lesions and the type of SCM. We reported the cutaneous findings of 14 adult patients who were investigated clinically and radiologically with a diagnosis of SCM. Hypertrichosis was the most common cutaneous lesion (79%) and faun tail was observed among six (55%) of the 11 patients who had hypertrichosis. The SCM was type I in all of the patients with faun tail. Silky down was observed among 5 (45%) patients as a solitary skin lesion or associated with dysplastic skin or capillary hemangioma. A statistically significant correlation between the skin markers and the type of SCM was found, and this correlation can help physicians weigh their diagnostic considerations in SCM.