Şüpheli Cilt Bulgusu Saptanan Çocuklarda Okült Spinal Disrafizm Sıklığı: Geriye Dönük Bir Çalışma

Year 2015, Volume: 9 Issue: 2, 85 - 89, 01.06.2015

Sevgi Yaşar Durmuş Çiğdem Üner Gonca Yılmaz

Abstract

Amaç: Hastanemize şüpheli cilt bulgusu yakınmasıyla başvuran ve rutin muayene sırasında cilt bulguları saptanan olgularda okült spinal disrafizm sıklığının saptanması ve sonuçların literatürle kıyaslanmasıdır.Gereç ve Yöntemler: Dr. Sami Ulus Kadın Doğum ve Çocuk Sağlığı ve Hastalıkları Hastanesine Haziran 2012 ve Haziran 2013 tarihleri arasında başvuran ve şüpheli cilt bulguları olan olgular geriye dönük olarak incelendi.Bulgular: Şüpheli cilt bulgusu saptanan 117 olgu çalışmaya dahil edildi. En sık cilt bulgusu 102 olguda saptanan sakral gamze (%87)’di. Diğer bulgular; 7 olguda kıllanma artışı (%6), 5 olguda sakral gamze ve kıllanma artışı birlikteliği (%4), 2 olguda sakral sinüs (%2), 1 olguda sakral kitle (%1)’di. Değerlendirilen tüm olguların %7 sinde okült spinal disrafizm saptandı.Sonuç: Okült spinal disrafizmin erken tanısında cilt bulguları önemli bir yer tutmaktadır. Bu nedenle özellikle yenidoğan muayenelerinde klinisyenin dikkatli olması gerekmektedir. Cilt bulguları saptanan çocuklarda görüntüleme yöntemleri akılcı bir şekilde kullanılmalıdır.

Keywords

Cilt, Okült spinal disrafizm

Suspicious Skin Findings: A Retrospective Study The Frequency of Occult Spinal Dysraphism in Children with

Abstract

Objective: The aim of this study was to determine the incidence of occult spinal dysraphism in patients complaining about skin findings and those with skin signs determined during routine medical examination and to compare the results with the literature.Material and Methods: Patients presenting to the Dr. Sami Ulus Obstetrics and Gynecology, Children Health and Disease Training and Research Hospital between July 2012 and July 2013 and found to have suspicious skin findings were evaluated retrospectively.Results: We included 117 cases with suspicious skin findings in this study. The most frequent skin finding was a sacral dimple (87%) that was found in 102 cases. The other findings were hypertrichosis (6%) in 7 cases, coexistence of sacral dimple and hypertrichosis (4%) in 5 cases, sacral sinus (2%) in 2 cases and sacral mass (1%) in 1 case. Occult spinal dysraphism was found in 7% of all evaluated cases.conclusion: Skin signs have an important role in the early diagnosis of occult spinal dysraphism. Clinicians should therefore be careful during examinations and especially newborn examinations. Imaging methods must be used wisely for children when skin signs are found

Keywords

Skin, Occult spinal dysraphism

References

• Sneineh AK, Gabos PG, Keller MS, Bowen JR. Ultrasonography of the spine in neonates and young infants with a sacral skin dimple. J Pediatr Orthop 2002; 22:761-2.
• Canpolat F, Akpınar H, Bilgiç Ö, Eskioğlu F. A sign of occult spinal dysraphism: Faun tail. The New Journal of Medicine 2011;28:57-8.
• McGovern M, Mulligan S, Carney O, Wall D, Moylett E. Ultrasound investigation of sacral dimples and other stigmata of spinal dysraphism. Arch Dis Child 2013;98:784-6.
• Stephen L. Spina Bifida Occulta (Occult Spinal Dysraphism). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF (eds). Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Saunders Elsevier, 2011:1999.
• Robinson AJ, Russell S, Rimmer S. The value of ultrasonic examination of the lumbar spine in infants with specific reference to cutaneous markers of occult spinal dysraphism. Clin Radiol 2005; 60:72-7.
• Ben-Sira L, Ponger P, Miller E, Beni-Adani L, Constantini S. Low-risk lumbar skin stigmata in infants: The role of ultrasound screening. J Pediatr 2009;155:864-9.
• Henriques JG, Pianetti G, Henriques KS, Costa P, Gusmão S. Minor skin lesions as markers of occult spinal dysraphisms-prospective study. Surg Neurol 2005;63 Suppl 1:S8-12.
• Chern JJ, Kirkman JL, Shannon CN, Tubbs RS, Stone JD, Royal SA, et al. Use of lumbar ultrasonography to detect occult spinal dysraphism. J Neurosurg Pediatr 2012;9:274-9.
• Martínez-Lage JF, Niguez BF, Pérez-Espejo MA, Almagro MJ, Maeztu C. Midline cutaneous lumbosacral lesions: Not always a sign of occult spinal dysraphism. Childs Nerv Syst 2006;22:623-7.