Newborn Cranial Alteration at Birth - a Clinical Case

Aplasia Cutis Congenita (ACC) is a rare disorder, with an estimated incidence of 0.5-1 in 10,000 live births, that is characterized by focal or widespread absence of epidermis, dermis and occasionally subcutaneous tissue. The precise etiology of ACC is unknown. This pathology can be noticed as a unique lesion or multiple lesions on any part of the body, being the most common localization the scalp, with or without an underlying bone and dura mater defect associated. This congenital alteration can be an isolated finding or it can be associated with other congenital malformations. In the majority of cases, the diagnosis of ACC is based upon clinical presentation. A complete and thorough physical examination should be performed in order to exclude other anomalies.
The management of these lesions is variable depending on the clinical characteristics – size, depth and other anomalies associated – ranging from a conservative approach to corrective surgery or a combination of both. The majority of scalp lesions do not require any specific therapy besides wound care and vigilance until closure, that usually takes several weeks or months. This type of lesions have a good prognosis.
When evaluating this kind of injury, other differential diagnoses should be considered such as obstetrical trauma from forceps, placement of fetal scalp electrodes or other potential birth lesions.
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References :

Gupta D. Aplasia cutis congénita. UpToDate®, last updated Jul 21, 2023. Brackenrich J, Brown A. Aplasia cutis congénita. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535403/ Chen Z, Ning J. A rare case of aplasia cutis congenita. Asian Journal of Surgery, Volume 46, Issue 11, 2023. Pages 4848-4849. ISSN 1015-9584, Available from: https://doi.org/10.1016/j.asjsur.2023.05.131.https://www.sciencedirect.com/science/article/pii/S1015958423008059