Management of aplasia cutis congenita of the scalp

Georgina Harvey, Nicholas S. Solanki, Peter Anderson, Bernard Carney, Broughton J. Snell

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Aplasia cutis congenita (ACC) is a rare condition commonly affecting the scalp in which there is a focal deficiency of cutaneous tissues of varying severity ranging from an absence of skin through to full thickness defects involving deeper elements such as bone and dura. Lesions of the scalp can be associated with complications including infection, hemorrhage, thrombosis, and seizures. Opinions in the current literature regarding management of this condition are varied with both conservative and surgical management advocated. Conservative treatment consists of regular wound dressings and systemic antibiotics, while surgical management commonly involves skin grafting and local flaps. Methods: A retrospective case review was performed to audit the outcomes of patients with ACC of the scalp managed at theWomen's and Children's Hospital (WCH) in Adelaide, Australia from 2002 to 2012. Cases were identified from admission coding diagnoses and data was retrieved from patient case notes. Results: Seventeen cases of ACC were identified. The most common location involved was the scalp vertex. Thirteen patients were managed conservatively and 4 had primary surgical intervention. Of the cases that were managed with primary surgery, 2 had complications. None of the conservatively managed patients had complications in the acute setting. Conclusions: At the WCH, we advocate adopting a conservative approach to management of ACC of the scalp. Defects can be successfully managed with a combination of regular dressings and systemic antibiotics. Regular wound monitoring is essential to detect any complications early to instigate appropriate treatment and determine the need for emergency surgical management. Management of Aplasia Cutis Congenita of the Scalp Georgina Harvey, MBBS,Nicholas S. Solanki, BMBS, BEng(Hons),Peter J. Anderson, MD(Edin), PhD, Bernard Carney, OAM, MBBS, and Broughton J. Snell, MBBS(Hons), BSc(Hons)Background: Aplasia cutis congenita (ACC) is a rare condition commonly affecting the scalp in which there is a focal deficiency of cutaneous tissues of varying severity ranging from an absence of skin through to full thickness defects involving deeper elements such as bone and dura. Lesions of the scalp can be associated with complications including infection, hemorrhage, thrombosis, and seizures. Opinions in the current literature regarding management of this condition are varied with both conservative and surgical management advocated. Conservative treatment consists of regular wound dressings and systemic antibiotics, while surgical management commonly involves skin grafting and local flaps. Methods: A retrospective case review was performed to audit the outcomes of patients with ACC of the scalp managed at theWomen's and Children's Hospital (WCH) in Adelaide, Australia from 2002 to 2012. Cases were identified from admission coding diagnoses and data was retrieved from patient case notes. Results: Seventeen cases of ACC were identified. The most common location involved was the scalp vertex. Thirteen patients were managed conservatively and 4 had primary surgical intervention. Of the cases that were managed with primary surgery, 2 had complications. None of the conservatively managed patients had complications in the acute setting. Conclusions: At the WCH, we advocate adopting a conservative approach to management of ACC of the scalp. Defects can be successfully managed with a combination of regular dressings and systemic antibiotics. Regular wound monitoring is essential to detect any complications early to instigate appropriate treatment and determine the need for emergency surgical management.

LanguageEnglish
Pages1662-1664
Number of pages3
JournalJournal of Craniofacial Surgery
Volume23
Issue number6
DOIs
Publication statusPublished - 1 Nov 2012
Externally publishedYes

Keywords

  • Aplasia cutis congenita
  • Cutis aplasia
  • Scalp

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Harvey, Georgina ; Solanki, Nicholas S. ; Anderson, Peter ; Carney, Bernard ; Snell, Broughton J. / Management of aplasia cutis congenita of the scalp. In: Journal of Craniofacial Surgery. 2012 ; Vol. 23, No. 6. pp. 1662-1664.
@article{12dc573b9a234b438729cddb141eeed9,
title = "Management of aplasia cutis congenita of the scalp",
abstract = "Background: Aplasia cutis congenita (ACC) is a rare condition commonly affecting the scalp in which there is a focal deficiency of cutaneous tissues of varying severity ranging from an absence of skin through to full thickness defects involving deeper elements such as bone and dura. Lesions of the scalp can be associated with complications including infection, hemorrhage, thrombosis, and seizures. Opinions in the current literature regarding management of this condition are varied with both conservative and surgical management advocated. Conservative treatment consists of regular wound dressings and systemic antibiotics, while surgical management commonly involves skin grafting and local flaps. Methods: A retrospective case review was performed to audit the outcomes of patients with ACC of the scalp managed at theWomen's and Children's Hospital (WCH) in Adelaide, Australia from 2002 to 2012. Cases were identified from admission coding diagnoses and data was retrieved from patient case notes. Results: Seventeen cases of ACC were identified. The most common location involved was the scalp vertex. Thirteen patients were managed conservatively and 4 had primary surgical intervention. Of the cases that were managed with primary surgery, 2 had complications. None of the conservatively managed patients had complications in the acute setting. Conclusions: At the WCH, we advocate adopting a conservative approach to management of ACC of the scalp. Defects can be successfully managed with a combination of regular dressings and systemic antibiotics. Regular wound monitoring is essential to detect any complications early to instigate appropriate treatment and determine the need for emergency surgical management. Management of Aplasia Cutis Congenita of the Scalp Georgina Harvey, MBBS,Nicholas S. Solanki, BMBS, BEng(Hons),Peter J. Anderson, MD(Edin), PhD, Bernard Carney, OAM, MBBS, and Broughton J. Snell, MBBS(Hons), BSc(Hons)Background: Aplasia cutis congenita (ACC) is a rare condition commonly affecting the scalp in which there is a focal deficiency of cutaneous tissues of varying severity ranging from an absence of skin through to full thickness defects involving deeper elements such as bone and dura. Lesions of the scalp can be associated with complications including infection, hemorrhage, thrombosis, and seizures. Opinions in the current literature regarding management of this condition are varied with both conservative and surgical management advocated. Conservative treatment consists of regular wound dressings and systemic antibiotics, while surgical management commonly involves skin grafting and local flaps. Methods: A retrospective case review was performed to audit the outcomes of patients with ACC of the scalp managed at theWomen's and Children's Hospital (WCH) in Adelaide, Australia from 2002 to 2012. Cases were identified from admission coding diagnoses and data was retrieved from patient case notes. Results: Seventeen cases of ACC were identified. The most common location involved was the scalp vertex. Thirteen patients were managed conservatively and 4 had primary surgical intervention. Of the cases that were managed with primary surgery, 2 had complications. None of the conservatively managed patients had complications in the acute setting. Conclusions: At the WCH, we advocate adopting a conservative approach to management of ACC of the scalp. Defects can be successfully managed with a combination of regular dressings and systemic antibiotics. Regular wound monitoring is essential to detect any complications early to instigate appropriate treatment and determine the need for emergency surgical management.",
keywords = "Aplasia cutis congenita, Cutis aplasia, Scalp",
author = "Georgina Harvey and Solanki, {Nicholas S.} and Peter Anderson and Bernard Carney and Snell, {Broughton J.}",
year = "2012",
month = "11",
day = "1",
doi = "10.1097/SCS.0b013e31826542de",
language = "English",
volume = "23",
pages = "1662--1664",
journal = "Journal of Craniofacial Surgery",
issn = "1049-2275",
number = "6",

}

Management of aplasia cutis congenita of the scalp. / Harvey, Georgina; Solanki, Nicholas S.; Anderson, Peter; Carney, Bernard; Snell, Broughton J.

In: Journal of Craniofacial Surgery, Vol. 23, No. 6, 01.11.2012, p. 1662-1664.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Management of aplasia cutis congenita of the scalp

AU - Harvey, Georgina

AU - Solanki, Nicholas S.

AU - Anderson, Peter

AU - Carney, Bernard

AU - Snell, Broughton J.

PY - 2012/11/1

Y1 - 2012/11/1

N2 - Background: Aplasia cutis congenita (ACC) is a rare condition commonly affecting the scalp in which there is a focal deficiency of cutaneous tissues of varying severity ranging from an absence of skin through to full thickness defects involving deeper elements such as bone and dura. Lesions of the scalp can be associated with complications including infection, hemorrhage, thrombosis, and seizures. Opinions in the current literature regarding management of this condition are varied with both conservative and surgical management advocated. Conservative treatment consists of regular wound dressings and systemic antibiotics, while surgical management commonly involves skin grafting and local flaps. Methods: A retrospective case review was performed to audit the outcomes of patients with ACC of the scalp managed at theWomen's and Children's Hospital (WCH) in Adelaide, Australia from 2002 to 2012. Cases were identified from admission coding diagnoses and data was retrieved from patient case notes. Results: Seventeen cases of ACC were identified. The most common location involved was the scalp vertex. Thirteen patients were managed conservatively and 4 had primary surgical intervention. Of the cases that were managed with primary surgery, 2 had complications. None of the conservatively managed patients had complications in the acute setting. Conclusions: At the WCH, we advocate adopting a conservative approach to management of ACC of the scalp. Defects can be successfully managed with a combination of regular dressings and systemic antibiotics. Regular wound monitoring is essential to detect any complications early to instigate appropriate treatment and determine the need for emergency surgical management. Management of Aplasia Cutis Congenita of the Scalp Georgina Harvey, MBBS,Nicholas S. Solanki, BMBS, BEng(Hons),Peter J. Anderson, MD(Edin), PhD, Bernard Carney, OAM, MBBS, and Broughton J. Snell, MBBS(Hons), BSc(Hons)Background: Aplasia cutis congenita (ACC) is a rare condition commonly affecting the scalp in which there is a focal deficiency of cutaneous tissues of varying severity ranging from an absence of skin through to full thickness defects involving deeper elements such as bone and dura. Lesions of the scalp can be associated with complications including infection, hemorrhage, thrombosis, and seizures. Opinions in the current literature regarding management of this condition are varied with both conservative and surgical management advocated. Conservative treatment consists of regular wound dressings and systemic antibiotics, while surgical management commonly involves skin grafting and local flaps. Methods: A retrospective case review was performed to audit the outcomes of patients with ACC of the scalp managed at theWomen's and Children's Hospital (WCH) in Adelaide, Australia from 2002 to 2012. Cases were identified from admission coding diagnoses and data was retrieved from patient case notes. Results: Seventeen cases of ACC were identified. The most common location involved was the scalp vertex. Thirteen patients were managed conservatively and 4 had primary surgical intervention. Of the cases that were managed with primary surgery, 2 had complications. None of the conservatively managed patients had complications in the acute setting. Conclusions: At the WCH, we advocate adopting a conservative approach to management of ACC of the scalp. Defects can be successfully managed with a combination of regular dressings and systemic antibiotics. Regular wound monitoring is essential to detect any complications early to instigate appropriate treatment and determine the need for emergency surgical management.

AB - Background: Aplasia cutis congenita (ACC) is a rare condition commonly affecting the scalp in which there is a focal deficiency of cutaneous tissues of varying severity ranging from an absence of skin through to full thickness defects involving deeper elements such as bone and dura. Lesions of the scalp can be associated with complications including infection, hemorrhage, thrombosis, and seizures. Opinions in the current literature regarding management of this condition are varied with both conservative and surgical management advocated. Conservative treatment consists of regular wound dressings and systemic antibiotics, while surgical management commonly involves skin grafting and local flaps. Methods: A retrospective case review was performed to audit the outcomes of patients with ACC of the scalp managed at theWomen's and Children's Hospital (WCH) in Adelaide, Australia from 2002 to 2012. Cases were identified from admission coding diagnoses and data was retrieved from patient case notes. Results: Seventeen cases of ACC were identified. The most common location involved was the scalp vertex. Thirteen patients were managed conservatively and 4 had primary surgical intervention. Of the cases that were managed with primary surgery, 2 had complications. None of the conservatively managed patients had complications in the acute setting. Conclusions: At the WCH, we advocate adopting a conservative approach to management of ACC of the scalp. Defects can be successfully managed with a combination of regular dressings and systemic antibiotics. Regular wound monitoring is essential to detect any complications early to instigate appropriate treatment and determine the need for emergency surgical management. Management of Aplasia Cutis Congenita of the Scalp Georgina Harvey, MBBS,Nicholas S. Solanki, BMBS, BEng(Hons),Peter J. Anderson, MD(Edin), PhD, Bernard Carney, OAM, MBBS, and Broughton J. Snell, MBBS(Hons), BSc(Hons)Background: Aplasia cutis congenita (ACC) is a rare condition commonly affecting the scalp in which there is a focal deficiency of cutaneous tissues of varying severity ranging from an absence of skin through to full thickness defects involving deeper elements such as bone and dura. Lesions of the scalp can be associated with complications including infection, hemorrhage, thrombosis, and seizures. Opinions in the current literature regarding management of this condition are varied with both conservative and surgical management advocated. Conservative treatment consists of regular wound dressings and systemic antibiotics, while surgical management commonly involves skin grafting and local flaps. Methods: A retrospective case review was performed to audit the outcomes of patients with ACC of the scalp managed at theWomen's and Children's Hospital (WCH) in Adelaide, Australia from 2002 to 2012. Cases were identified from admission coding diagnoses and data was retrieved from patient case notes. Results: Seventeen cases of ACC were identified. The most common location involved was the scalp vertex. Thirteen patients were managed conservatively and 4 had primary surgical intervention. Of the cases that were managed with primary surgery, 2 had complications. None of the conservatively managed patients had complications in the acute setting. Conclusions: At the WCH, we advocate adopting a conservative approach to management of ACC of the scalp. Defects can be successfully managed with a combination of regular dressings and systemic antibiotics. Regular wound monitoring is essential to detect any complications early to instigate appropriate treatment and determine the need for emergency surgical management.

KW - Aplasia cutis congenita

KW - Cutis aplasia

KW - Scalp

UR - http://www.scopus.com/inward/record.url?scp=84873313412&partnerID=8YFLogxK

U2 - 10.1097/SCS.0b013e31826542de

DO - 10.1097/SCS.0b013e31826542de

M3 - Article

VL - 23

SP - 1662

EP - 1664

JO - Journal of Craniofacial Surgery

T2 - Journal of Craniofacial Surgery

JF - Journal of Craniofacial Surgery

SN - 1049-2275

IS - 6

ER -