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Early recognition of occult spinal dysraphism through cutaneous stigmata
  1. Manju Paul1,
  2. Helen Goodyear2,
  3. Desiderio Rodrigues3,
  4. Annette Loffeld1
  1. 1Department of Dermatology, Heart of England NHS Foundation Trust, Birmingham, UK
  2. 2Department of Paediatrics, Heart of England NHS Foundation Trust, Birmingham, UK
  3. 3Birmingham Children's Hospital, Birmingham, UK
  1. Correspondence to Dr Manju Paul, Department of Dermatology, Heart of England NHS Foundation Trust, Birmingham, UK; manjupaul{at}doctors.org.uk

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An 8-month-old girl born with a port wine stain and a dimple in the sacral area presented with a 5-month history of a gradually increasing swelling at this site. There was no history of fluid leak from the dimple; she had not been unwell and her developmental milestones were normal. Cutaneous examination of the lumbosacral area revealed a midline soft cystic swelling measuring 6 cm with a port wine stain of 1.5 cm at its dome. There was a small dimple at the inferior aspect of this swelling. She had a normal neurological examination and no anogenital abnormalities. MRI scan showed a subcutaneous cyst communicating with the spine through the posterior element of S3­­–S5­ and extending up to the L5 level. She was …

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