National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Aplasia cutis congenita


Other Names:
Aplasia cutis congenita nonsyndromic; Congenital defect of skull and scalp; Scalp defect congenital
Categories:
Aplasia cutis congenita is a condition in which there is congenital (present from birth) absence of skin, with or without the absence of underlying structures such as bone.[1] It most commonly affects the scalp, but any location of the body can be affected.[2] While most people with aplasia cutis congenita have no other abnormalities, some people have congenital malformations involving the cardiovascular (heart), gastrointestinal, genitourinary, and central nervous systems.[1] The cause of this condition is unclear and appears to be multifactorial (many different factors appear to play a role); contributing factors may include teratogens, genes, trauma, and compromised blood flow to the skin.[1] 
Last updated: 9/17/2016

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms Other Names
Learn More:
HPO ID
80%-99% of people have these symptoms
Aplasia cutis congenita over the scalp vertex 0004471
Calvarial skull defect
Cranial defect
Skull defect
[ more ] 		0001362
Congenital localized absence of skin 0007383
Spinal dysraphism 0010301
30%-79% of people have these symptoms
Skin ulcer
Open skin sore
0200042
5%-29% of people have these symptoms
Abnormality of bone mineral density 0004348
Facial palsy
Bell's palsy
0010628
Finger syndactyly 0006101
Prolonged bleeding time 0003010
Toe syndactyly
Fused toes
Webbed toes
[ more ] 		0001770
Percent of people who have these symptoms is not available through HPO
Autosomal dominant inheritance 0000006
Autosomal recessive inheritance 0000007
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Last updated: 7/1/2020
There is no one cause for all cases of aplasia cutis congenita.[2][3] The condition is thought to be multifactorial, which means that several factors likely interact to cause the condition.[1][3] Factors that may contribute include genetic factors; teratogens (exposures during pregnancy that can harm a developing fetus) such as methimazole, carbimazole, misoprostol, and valproic acid; compromised vasculature to the skin; and trauma.[1][3][1] Some cases may represent an incomplete or unusual form of a neural tube defect.[4] Familial cases of aplasia cutis congenita have been reported.[1][4] Cases that appear to be genetic may be inherited in an autosomal dominant or autosomal recessive manner.[4]

Last updated: 9/17/2016
Treatment of aplasia cutis congenita varies depending on the condition of the infant. Conservative treatment is preferred.[5] Small areas usually heal on their own over time. Gentle cleansing and application of bland ointments or silver sulfadiazine can help prevent infection. If infection occurs, antibiotics can be used.[3][6] Recently, a variety of specialized dressing materials have been developed and used.[3] Larger lesions may require surgery.[3][6] Ultimately, the decision to use medical, surgical, or both forms of therapy depends primarily on the size, depth, and location of the skin defect.[3]

    Last updated: 9/13/2016
    The long-term outlook (prognosis) for people with aplasia cutis congenita is usually excellent. If the condition is associated with other abnormalities or malformations, the prognosis then depends on the nature and severity of the other condition(s).[3]

    Major complications of aplasia cutis congenita are rare, but can include hemorrhage, secondary local infection, meningitis, or sagittal sinus thrombosis. Larger affected areas associated with underlying bony defects can cause death due to central nervous system infection, or hemorrhage from the sagittal sinus. Complications can also result from associated abnormalities or malformations, when present.[3]
    Last updated: 9/13/2016

    If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

    If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

    You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

    Healthcare Resources

    Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

    Conditions with similar signs and symptoms from Orphanet
    Differential diagnoses include traumatic lesions, localized scalp infections, dermoid cyst (facial, cervical, nasal or involving the central nervous system), isolated encephalocele, meningocele and nodular neuronal heterotopia. As the child grows and scarring occurs, sebaceous nevus, nevus psiloliparus, localized scleroderma and other types of cicatricial alopecia should be considered. Hypertrophic scars can be mistaken for scalp tumors. ACC can occur in association with inherited epidermolysis bullosa and with epidermal and organoid nevi (didymosis aplasticosebacea). It may also form part of numerous syndromes including: chromosomal abnormalities (mainly trisomy 13), Adams-Oliver syndromes, Johanson-Blizzard, SCALP syndrome, focal facial dermal dysplasia, oculocerebrocutaneous syndrome, scalp-ear-nipple syndrome, Toriello-Lacassie-Droste syndrome, aplasia cutis congenita-intestinal lymphangiectasia syndrome, aplasia cutis-myopia syndrome, cutis verticis gyrata-thyroid aplasia-intellectual disability syndrome, and others.
    Visit the Orphanet disease page for more information.

    Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

    Clinical Research Resources

    • The Centers for Mendelian Genomics program is working to discover the causes of rare genetic disorders. For more information about applying to the research study, please visit their website.

    Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

    Parent Matching Organizations

    • Contact a Family is a UK-wide charity providing advice, information and support to individuals affected by various health conditions. They enable parents, families, and individuals to get in contact with others, on a local, national, and international basis. Each year they reach at least 275,000 families. Click on Contact a Family to view the Making Contact page for aplasia cutis congenita.

    These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

    Where to Start

    • DermNet NZ is an online resource about skin diseases developed by the New Zealand Dermatological Society Incorporated. DermNet NZ provides information about this condition.
    • Genetics Home Reference contains information on Aplasia cutis congenita. This website is maintained by the National Library of Medicine.
    • The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

    In-Depth Information

    • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
    • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
    • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
    • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
    • PubMed is a searchable database of medical literature and lists journal articles that discuss Aplasia cutis congenita. Click on the link to view a sample search on this topic.

    Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.

    1. Tamara Buchel, Wendy Devaul, Keith Frey. Photo Quiz: Newborn with a Scalp Lesion. American Family Physician. 2005 Oct 15; 72(8):1589-1571. http://www.aafp.org/afp/2005/1015/p1569.html.
    2. Joseph G. Morelli. Chapter 647 - Cutaneous Defects. In: Robert M. Kleigman. Nelson Textbook of Pediatrics, 18th edition. Philadelphia, PA: Saunders Elsevier; 2007;
    3. Wan J. Aplasia Cutis Congenita. Medscape Reference. March 2, 2016; http://emedicine.medscape.com/article/1110134-overview.
    4. Mary Wu Chang, Seth J. Orlow. Neonatal, Pediatric, and Adolescent Dermatology. In: Irwin M. Freedberg, Arthur Z. Eisen, Klaus Wolff, K. Frank Austen, Lowell A. Goldsmith, and Stephen I. Katz. Fitzpatrick’s Dermatology in General Medicine, 6th edition. New York: McGraw-Hill; 2003;
    5. Duan X, Yang G, Yu D, Yu C, Wang B, Guo Y. Aplasia cutis congenita: A case report and literature review. Exp Ther Med. 2015 Nov; 10(5):1893-1895. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4665749/.
    6. Ngan V. Aplasia cutis. DermNet NZ. September 3, 2015; http://www.dermnetnz.org/topics/aplasia-cutis/.
    7. MR Vijayashankar. Aplasia cutis congenita: A case report. Dermatology Online Journal. 2005; http://dermatology.cdlib.org/113/case_presentations/aplasia/vijayashankar.html.