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Dermal sinus tract in Adult
Other Resources UpToDate PubMed

Dermal sinus tract in Adult

Contributors: Nnenna Agim MD, Lowell A. Goldsmith MD, MPH, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

A midline dermal sinus tract is a manifestation of spinal dysraphism resulting from incomplete closure of the embryonic neuroectoderm early in development. The midline lesion with a central pit may be an important clue to the connection of the skin surface to the spinal canal, which occurs in approximately 50% of dermal sinuses.

Lesions occur most frequently in the lumbosacral region but can be seen anywhere along the midline (ie, cervical, thoracic, scalp regions) and in the genital area. Lateral congenital dermal sinuses may occur on the buttocks. They may be associated with other congenital skin lesions such as sacral hypertrichosis, lipoma, acrochordon / pseudotail, hemangioma, or capillary malformation. A multiplicity of congenital lesions over the midline raises risks for underlying spinal dysraphism.

Dermal sinus tracts can leak fluid (spinal fluid), and neurological deficits may be present. Meningeal infections, sometimes with an unusual organism(s), are a further complication.

Codes

ICD10CM:
Q06.8 – Other specified congenital malformations of spinal cord

SNOMEDCT:
70499005 – Congenital dermal sinus

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Pseudodermal sinuses (dermal sinus-like stalk) – May have atrophic epidermis (aplasia cutis, "cigarette paper" scarring); have fibrous tissue without a skin opening, but often have associated spinal cord abnormalities and need to be investigated.
  • Pilonidal cyst / abscess – Can appear somewhat similar, but the dermal sinus is usually found above the gluteal cleft and the pilonidal disorder is within the gluteal cleft.

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:03/17/2020
Last Updated:03/17/2020
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Dermal sinus tract in Adult
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Dermal sinus tract : Sacral region of back
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