At What Age Can Congenital Scalp Cutis Aplasia Be Excised?
Q: Dr. Eppley, My son is 5 years old and was born with scalp aplasia cutis congenita. Around 3 x3 xm on the scalp. The dermatologists does not wish to help us correct this until my son has a say on this when he is older which I think is ridiculous as a parent.
A: Thank you for your inquiry. Congenital scalp cutis aplasia areas can be excised at any age. The real question is not whether it can be excised but whether it can be primarily closed without undue tension or excessively long incisions from scalp rotational flaps. Scalp surgery in a growing head is interesting in that scars do expand with growth so many of these scalp surgeries require further surgery in the future for scar widening from the expansion of skull growth. But certainly it can be substantially reduced. I would need to see some pictures of it for further assessment.
Some cutis aplasias have either very thin skull bone underneath them or rarely I have seen them with areas of missing skull bone underneath them. But I assume that the latter is not evident in your son’s case.
Dr. Barry Eppley