M Cherubino1,2, F Maggiulli1, R Dibartolo1, L Valdatta1,2. 1. Plastic and Reconstructive Unit, Ospedale di Circolo e Fondazione Macchi, Varese, Italy. 2. University of Insubria, Varese Italy.
Abstract
INTRODUCTION: Aplasia cutis congenita (ACC) is a rare congenital disease, characterised by absence of skin, that can affect different parts of the body. ACC is more frequent on the scalp, but can involve limbs, with partial-or total-thickness loss of skin, with a functional impairment of the joint affected. There is no clear indication for surgical or conservative treatment, therefore, it would be helpful to find scientific support for the optimal treatment strategies. CLINICAL PRESENTATION: We present a case of a newborn female, with six wounds on the inferior limbs, treated with conservative therapy. To prevent infection and promote healing, the defects were kept moist and covered with non-adherent/antimicrobical dressings. Complete wound healing occurred in eight weeks. The duration of follow-up was three years. RESULTS: In this kind of ACC with superficial partial-thickness wounds of the lower limbs, conservative treatment was successful. The same conservative treatment can be proposed for larger or deeper wounds of lower limbs with no involvement of underlying structures, with delayed scar excision after the complete growth of the patient. ACC scar excision could require complex tissue rearrangement, tissue expansion, or skin grafting. CONCLUSION: In the evaluation for treatment of ACC of inferior limbs, even in cases of total-thickness skin loss, even on joints, the conservative approach could be considered as the first choice. DECLARATION OF INTEREST: None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.
INTRODUCTION:Aplasia cutis congenita (ACC) is a rare congenital disease, characterised by absence of skin, that can affect different parts of the body. ACC is more frequent on the scalp, but can involve limbs, with partial-or total-thickness loss of skin, with a functional impairment of the joint affected. There is no clear indication for surgical or conservative treatment, therefore, it would be helpful to find scientific support for the optimal treatment strategies. CLINICAL PRESENTATION: We present a case of a newborn female, with six wounds on the inferior limbs, treated with conservative therapy. To prevent infection and promote healing, the defects were kept moist and covered with non-adherent/antimicrobical dressings. Complete wound healing occurred in eight weeks. The duration of follow-up was three years. RESULTS: In this kind of ACC with superficial partial-thickness wounds of the lower limbs, conservative treatment was successful. The same conservative treatment can be proposed for larger or deeper wounds of lower limbs with no involvement of underlying structures, with delayed scar excision after the complete growth of the patient. ACC scar excision could require complex tissue rearrangement, tissue expansion, or skin grafting. CONCLUSION: In the evaluation for treatment of ACC of inferior limbs, even in cases of total-thickness skin loss, even on joints, the conservative approach could be considered as the first choice. DECLARATION OF INTEREST: None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.