Document Detail


Spinal dermal sinus and pseudo-dermal sinus tracts: two different entities.
MedLine Citation:
PMID:  20978770     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Occult spinal dysraphism (OSD) encompasses various conditions. A dermal sinus tract (DST) consists of a duct communicating to the skin with deep structures that carries an important risk of infection. A different lesion consisting of a translucent skin opening and a fibrous tract that lacks a lumen can also be found in OSD. We termed this lesion pseudo-dermal sinus tract.
PATIENTS AND METHODS: We reviewed clinical features of 20 patients with spinal skin orifices. The patients were classified into two categories: group 1 comprised children with true DST and group 2 included patients with skin dimples resembling a DST.
AIMS: The aim of this study was to analyze differential features of patients in these two groups as they behaved dissimilarly in regard to clinical significance and outcomes, especially those concerning infectious risk.
RESULTS: Children of group 1 (n = 8) presented with tiny skin orifices and with superficial or deep infection. In contrast, group 2 (n = 12) mostly manifested with neurological symptoms. No patient in group 2 developed an infection preoperatively. In both groups, magnetic resonance showed tracts that ended in different structures. Histopathology of the lesions were dissimilar, those of group 1 being hollow tubular structures lined by epithelium while those of group 2 being solid tracts of fibrous connective tissue.
CONCLUSIONS: DST constitutes a clinicopathological diagnosis. Although sharing some common cutaneous and neuroimaging findings, both groups behaved differently. Patients of group 1 tended to show up with infection requiring urgent surgery. Patients of group 2 often presented with neurological manifestations and skin lesions, but needed no immediate operation.
Authors:
Juan F Martínez-Lage; María José Almagro; Belén Ferri-Ñiguez; Virginia Izura Azanza; Cristina Serrano; Ernesto Domenech
Publication Detail:
Type:  Journal Article     Date:  2010-10-27
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  27     ISSN:  1433-0350     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-14     Completed Date:  2011-07-06     Revised Date:  2011-09-07    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  609-16     Citation Subset:  IM    
Affiliation:
Regional Service of Neurosurgery, Virgen de la Arrixaca University Hospital, El Palmar, 30120, Murcia, Spain. juanf.martinezlage@cablemurcia.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Female
Humans
Infant
Male
Neural Tube Defects / pathology
Retrospective Studies
Skin Abnormalities / pathology*
Skin Diseases / pathology*
Comments/Corrections
Comment In:
Childs Nerv Syst. 2011 Aug;27(8):1189-91; author reply 1193   [PMID:  21656011 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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