Dermal sinus tract

Occult spinal dysraphisms (OSDs) are caused by various defects in the embryogenesis of the spinal cord and represent an obstacle to the ascent of the conus, which allows the conus to pass from the lower levels of the spinal canal to the final position between L1 and L2 during normal foetal life. When an OSD tethers the spinal cord at the lower levels, it can lead to neurological symptoms, better known as tethered cord syndrome. Surgical treatment of OSD is primarily aimed at untethering the spinal cord. In asymptomatic patients, this can protect against the long-term development of neurological deficits...

Congenital anomalies and defects of the skull base and calvarium encompass a broad and complex spectrum of pathologies. The clinical presentation is highly variable, and these anomalies may be discovered incidentally in asymptomatic individuals. Radiological assessment plays a pivotal role in precisely characterizing these abnormalities, facilitating the diagnostic process, and assisting in any preoperative preparation.

The cervical and thoracic dermal sinuses are rare entities, conforming epithelium-lined tracts that extend from an opening in the skin through a corridor to the layers of the spinal cord. They are commonly detected in early childhood; however, adult reports are singularly rare, especially in cervical regions. We report a very unusual case of a 45-year-old Mexican female who developed progressive left-side weakness and dexterity suffered from childhood, getting worse in the last year. Physical examination revealed a soft, congenital round cystic lesion in the dorsal-midline skin at the level of C4-C5 vertebrae with no previous treatment received...

Dermal sinus tracts (DSTs) are congenital lesions that connect the cutaneous ectoderm with the underlying neuroectodermal tissues. They are typically midline, solitary lesions. Multiple, and atypically located DSTs have been only rarely described. We present two cases of multiple and laterally located DSTs. The first presented with bacterial meningitis and two tracts in the right buttock, one of which entered the spinal canal through the S3 neural foramen. The second child had three midline lumbar DSTs, one subcutaneous dermoid cyst and one intradural epidermoid cyst...

Rudimentary meningoceles of the spine with dural extension are very rare and warrant surgical excision to prevent infection and long-term neurological deficits in pediatric patients. We present the case of a 5-month-old infant with a tethered spinal cord secondary to a rudimentary meningocele. The patient presented shortly after birth with a midline cervical dimple that was evaluated for a suspected dermal sinus tract. Magnetic resonance imaging scan of the spine showed a sinus tract with intradural extension to C2-3 and external opening at the level of spinous process C5...

Jarcho-Levin syndrome (JLS) is a congenital dysostosis characterized by multiple vertebral and intrinsic rib abnormalities. JLS and neural tube abnormalities rarely occur together. There have been few cases of JLS associated with a split spinal cord malformation (diastematomyelia). A dorsal dermal sinus is a tract from the skin that may end in soft tissue, epidural space, or most commonly intradural. We report the case of a 5-day-old male neonate with JLS who presented with respiratory distress immediately after birth...

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a relapsing nature that has a significant impact on the patient's quality of life. The clinical presentation of the disease includes deep dermal abscesses and sinus tracts. Long-term affliction of the disease may lead to contractures, scars and fibrosis. Management is still challenging and varies from medical to surgical options. We report the following case of a man in his 30s who presented with severe HS in the axillae, groins, perineum and lower sacral region...

We report an unusual case of the vulval sinus with persistent seroanguinous discharge in a 59-year-old postmenopausal woman. Examination revealed a 9-cm isolated sinus tract in the right labiocrural fold. This sinus tract was excised under anesthesia. Histological analysis showed skin with a deep dermal sinus tract showing edematous and heavily inflamed granulation tissue. There was no evidence of malignancy or dysplasia. Hidradenitis was ruled out on histology. This case report summarizes the importance of early diagnosis and prompt treatment involving complete excision of the vulval sinus to reduce long-term morbidity and consequences of this rare entity...

Hidradenitis suppurativa (HS), more commonly known as acne inversa, occurs due to chronic inflammation of the body's apocrine glands, most commonly affecting areas of the body where there is prolonged skin-on-skin friction. HS affects approximately 4% of the United States population, most commonly women in their second or third decade of life, especially those of African American ethnicity. HS presents as tender subcutaneous nodules which often rupture, leading to the formation of painful dermal abscesses which undergo fibrosis and lead to the formation of extensive sinus tracts, a phenomenon known as "tunneling"...

A broad spectrum of spinal pathologies can affect the pediatric population. Ultrasound (US) is the primary modality for pediatric spine assessment due to its widespread availability, non-requirement of sedation, and absence of ionizing radiation. Supplementing this, MRI offers an in-depth exploration of these conditions, aiding in preoperative strategizing. In this review, we examine the clinical indications, methodologies, and protocols for US and MRI scans of the pediatric spine. Additionally, we illustrate normal pediatric spinal anatomy, highlighting several examples of normal variants that are often misinterpreted...

The publication of a comprehensive report on limited dorsal myeloschisis by the senior author (DP) in 2010 has brought full attention to the concept of limited myeloschisis that he first formulated in 1992 and ignited interests in the whole spectrum of focal spinal nondisjunctional disorders. Now that focal nondisjunctional disorders have become well known, new clinical reports on these conditions or relevant subjects are frequently seen. Here we present an updated review on the full spectrum of focal spinal nondisjunctional disorders and extend the scope to include a discussion on the embryogenesis of cranial focal nondisjunctional malformations...

BACKGROUND AND IMPORTANCE: Congenital dermal sinus tract (DST) is a rare spinal dysraphism characterized by a persistent tract lined by epithelial cells, beginning at the epidermis and terminating in deeper tissue layers. With 1% of all congenital DST cases found in the cervical region, only 4% of all cases are diagnosed after the age of 20. CLINICAL PRESENTATION: In this case, a 65-year-old woman with a congenital DST at the cervical level presented with symptoms of neck and some arm pain, suboccipital headaches, and unique external characteristics...

Dermoid cysts are benign developmental anomalies that can occur anywhere along the neuroaxis or embryonic lines of fusion. While intracranial dermoid cysts at the midline frequently have an associated nasal or subcutaneous sinus tract, it is quite rare to encounter an intracranial dermoid cyst off the midline with a lateral sinus tract. Standard practice for the treatment of dermoid cysts is surgical resection to minimize the risks of meningitis, abscess, mass effect, neurologic deficit, and/or death.  A 3-year-old male with a history of DiGeorge syndrome presented with right orbital cellulitis and a right-sided dermal pit...

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, inflammatory, debilitating disorder of the pilosebaceous unit. Dermal tunnels, sinus tracts, or fistulas are unique features of HS. One may hypothesize that HS tunnels remain active and may contribute to inflammation and disease severity. SUMMARY: Increased inflammatory infiltrate with an increased number and densities of immune cells was reported in HS tunnels. Moreover, significantly higher levels of IL-36, Il-17A, IL-17C, IL-17F, and CXCL8 mRNA compared to non-tunnel HS skin were found...

INTRODUCTION: A dermal sinus tract (DST) is an uncommon type of spinal dysraphisms characterized by a tract lined with stratified squamous epithelium that extends from the subcutaneous tissue to the underlying thecal sac or neural tube. These developmental anomalies can present asymptomatically with cutaneous abnormalities or with devastating complications. Usually, it is presented as a unique lesion, and there are only a few reports that show multiple sinuses, and none of them associated with midline brain malformations...

BACKGROUND: Myxopapillary ependymoma (MPE) is typically benign and found in the conus medullaris and/or filum terminale, although rare cases of subcutaneous and extra-axial MPE have been reported. The co-occurrence of MPE, tethered cord syndrome (TCS) with lipoma of the filum terminale, and a dermal sinus tract is extremely rare, with only 6 reported cases in the literature. Here, the authors present the first case, to their knowledge, of an extra-axial, subcutaneous MPE co-presenting with TCS, lipoma of the filum terminale, and a dermal sinus tract and discuss the underlying pathobiology...

The dermal sinus tract (DST) is an infrequent form of spina bifida occulta that can be complicated by infections. This is a case report of a child with a rare association of DST complications, namely hydromyelia and intramedullary abscess. A 1-year-old male child was admitted to the hospital with a history of fever and progressive loss of lower-limb movements and the presence of an ostium in the midline of the lumbar region and cutaneous stigmas with no secretion discharge. Computed tomography and magnetic resonance imaging (MRI) of the thoracolumbar spine revealed an extensive intradural T12-S1 abscess and cystic dilatation of the central medullary canal (hydromyelia) from T2 to T12...

OBJECTIVE: To summarize the clinical manifestations, imaging characteristics and experience of surgical treatment of tethered cord syndrome (TCS) accompanied by dermal sinus tract (DST) in adulthoods. METHODS: The authors retrospectively analyzed a series of 25 adult patients with TCS due to DST that were surgically treated under microscope from September 2010 to October 2019. There were 10 males and 15 females with an average age of 29.7 years (rang, 18-48 years)...

INTRODUCTION: An extension of the dermoid cyst below the nasal bone has been identified in 10% of patients in a large series of nasal dermoid cysts, but these are generally easily identifiable and connected to the tract. To date, no previous reports have documented a case with intraosseous dermoid cyst which was completely hidden in the nasal bone. CASE PRESENTATION: An 8 year-old previously healthy female was initially found to have a small pit on her nasal dorsum...

INTRODUCTION AND IMPORTANCE: Tuberculosis is an age old disease caused by Mycobacterium tuberculosis which has been a menace to public health and thwarting economic growth. Pulmonary tuberculosis being the most common type, extra pulmonary tuberculosis has a greater association with HIV and multidrug resistant tuberculosis. Cutaneous tuberculosis accounts for 1-1.5 % of extra pulmonary tuberculosis. CASE PRESENTATION: A 32 year old female presented to the outpatient department with a two month history of ulcer over the sole of the foot with multiple discharging sinuses and surrounding induration...