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Dermatology · Dermatology: aplasia cutis congenita
Sample itemA newborn has a 2 cm well-demarcated, ulcerated, hairless scalp defect at the vertex surrounded by a ring of darker, longer hair. What does this ring suggest, and what should be done?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Hair collar sign, suggesting an underlying neural tube defect; image the underlying brain and spine
Aplasia cutis congenita is a congenital absence of skin, commonly at the scalp vertex. A ring of long dark hair around the lesion (hair collar sign) can signal an underlying neural tube defect, so neuroimaging is advised. Small lesions heal with conservative care.
Option by option
A. Normal variant; no investigation needed
Investigation is needed because of possible neural tube defect.
B. Hair collar sign, suggesting an underlying neural tube defect; image the underlying brain and spine (correct)
Correct. The hair collar sign calls for imaging.
C. Tinea capitis; start griseofulvin
Tinea capitis is not present at birth.
D. Neonatal herpes; start acyclovir
Herpes would show vesicles in an unwell infant.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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