Dermal sinus tract
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.
Q06.8 – Other specified congenital malformations of spinal cord
70499005 – Congenital dermal sinus
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.
- – Can appear somewhat similar, but the dermal sinus is usually found above the gluteal cleft and the pilonidal disorder is within the gluteal cleft.