Faun tail: a rare cutaneous stigma of spinal dysraphism

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A 13-year-old girl was referred to our dermatology outpatient clinic for the treatment of a congenital, circumscribed, hypertrichotic area on the lumbosacral region because it was cosmetically embarrassing. Dermatologic examination revealed a 25 × 15 cm circumscribed hypertrichotic area on the lumbosacral region. Coarse, dark, terminal hairs were observed, but the underlying skin was normal (Fig. 1). The lesion had been present since birth. Her history also revealed back pain, which developed by 3 years of age, and a long history of urinary incontinence. On neurologic examination, no motor weakness or sensory changes were observed. On orthopedic examination, minimal atrophy and 2 cm shortening of the right leg were detected, and the right foot was smaller than the left. There was an accentuation of lumbar lordosis. There was no history of a similar lesion in the family. There was no consanguinity in the relatives.Magnetic resonance imaging and computed tomography findings included diastematomyelia between T10 and L2 levels, minimal spina bifida at L2–L3 levels, mild tethered cord, and a fat density mass at L1 level behind the left lamina. Complete blood cell count, erythrocyte sedimentation rate, and blood chemistry were within the normal ranges.The patient underwent lumbar laminectomy with excision of the lipoma and release of the tethered cord, and a type II diastematomyelia was detected at operation.A diagnosis of faun tail with underlying spinal dysraphism was made. There was also associated foot deformity and urinary incontinence as late sequelae of spinal dysraphism. The patient had been shaving the lesion periodically. We recommended laser epilation.

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