Site Under Construction

Schimmelpenning syndrome with didymosisaplasticosebacea in an infant

Jo Faustine Q. Manzano, M; Victoria P Guillano MD, FPDS

Abstract

Introduction:

Schimmelpenning syndrome may encompass abnormalities of the cardiovascular, skeletal, ophthalmologic and urogenital systems. Nevus sebaceous is a hallmark finding and ophthalmologic findings are seen in 59% of the cases which include colobomas and choristomas

 

Case:

A 1-month-old female presented with a verrucous plaque over the scalp and right zygomatic area upon birth. Physical examination reveals a linear yellowish alopecic verrucous plaque over the right frontal region, yellowish alopecic verrucous plaque topped with a skin colored papule over the right zygomatic region, conjunctival mass over the right eye and an atrophic patch with areas of circular erosion over the right occipital region. Ballard score and reflexes were appropriate for gestational age. Newborn screening was normal and otoacoustic-emission-test revealed no hearing loss. She was referred to an ophthalmologist and was assessed to have a lipodermoid, right upper eyelid and optic nerve coloboma. Cranial CT scan is unremarkable. Histopathology showed an increase in number of sebaceous glands with malformed hair units. She was managed holistically and does not have seizures and no secondary development of tumors in the nevus sebaceous.

 

Conclusion:

Schimmelpenning syndrome is usually associated with the clinical triad of nevus sebaceous, mental retardation and seizures. In this case, seizures were absent, however, there is an associated lipodermoid, right upper eyelid and right optic nerve coloboma. In addition, she also presented with aplasia cutis congenita. Hence, it is important to look for other manifestations when patients present with nevus sebaceous because management requires collaboration with different specialties.

References

  1. Shwu-Meei W, Ya-Ju H, Kuo-Ming C, Hsiang-Ling T, Chih-Ping C.Schimmelpenning Syndrome: A Case Report and Literature Review. J of Pediatr and Neonatol (2014) 55, 487-490.
  2. Jaqueti G, Requena L, Sanchez Yus E. Trichoblastoma is the most common neoplasm developed in nevus sebaceus of Jadassohn: a clinicopathologic study of a series of 155 cases. Am J Dermatopathol2000;22:108-18.
  3. Insler MS, Davlin L. Ocular findings in linear sebaceous naevus syndrome. Br J Ophthalmol1987;71:268-272.
  4. Menascu S, Donner E. Linear Nevus Sebaceous Syndrome: Case Reports and Review of the Literature, J Pediatr Neurol. March 2008Volume 38, Issue 3, Pages 207–210.
  5. Lovejoy Jr FH, Boyle Jr WE. Linear nevus sebaceous syndrome: report of two cases and a review of the literature. Pediatrics 1973;52:382-7.
  6. Van de Warrenburg BP, van Gulik S, Renier WO, Lammens M, Doelman JC. The linear naevus sebaceous syndrome. Clin Neurol Neurosurg1998;100:126-32.
  7. Levin S, Robinson RO, Aicardi J, Hoare RD. Computed tomographyappearance in the linear sebaceous naevus syndrome. Neuroradiology 1984;26:469-72.
  8. Zutt M, Strutz F, Happle R, Habenicht EM, Emmert S, Haenssle HA, Kretschmer L, Neumann CH. SchimmelpenningeFeuersteineMims syndrome with hypophosphatemic rickets. Dermatology 2003;207:72-6.
  9. Eisen DB, Michael DJ. Sebaceous lesions and their associated syndromes: part II. J Am Acad Dermatol 2009;61: 563-78.
  10. Alper J, Holmes L. The Incidence and significance of birthmarks in a cohort of 4641 new-borns. Pediatr Dermatol. 1983;1:58–66.
  11. Idriss MH, Elston DM. Secondary neoplasms associated with nevus sebaceous of Jadassohn: a study of 707 cases. J Am Acad Dermatol. 2014;70:332–337.
  12. Kawakami Y, Hafner C, Oyama N, Yamamoto T. A case of sebaceous naevus of the leg with secondarily developed trichoblastoma. Acta DermVenereol. 2010;90:194–195.
  13. Arakawa Y, Nakai N, Katoh N. Rare case of basal cell carcinoma arising in a nevus sebaceous on the upper arm. J Dermatol. 2012;39:931–932.
  14. Cribier B, Scrivener Y, Grosshans E: Tumors arising in nevus sebaceous: A study of 596 cases. J Am Acad Dermatol 42:63-68, 2000.
  15. Happle R. The group of epidermal nevus syndromes Part I. Well defined phenotypes. J Am Acad Dermatol. 2010 Jul;63(1):1-22; quiz 23-4.
  16. Happle R. The group of epidermal nevus syndromes Part II. Less well defined phenotypes. J Am Acad Dermatol. 2010 Jul;63(1):25-30; quiz 31-2.
  17. Happle R, Konig A. Didymosisaplasticosebacea: Coexistence of aplasia cutis congenita and nevus sebaceus may be explained as a twin spot phenomenon. Dermatology 2001;202:246–248.
  18. Santibanez-Gallerani A, Marshall D, Duarte AM, Melnick SJ, Thaller S. Should nevus sebaceous of Jadassohn in children be excised? A study of 757 cases, and literatura review. J Craniofac Surg. 2003;14:658-60.2003;56:171-3.
  19. Barkham MC, Moss C, White N, Brundler MA. Should naevus sebaceous be excised prophylactically? A clinical audit. J PlastReconstAesthet Surg. 2007;60:1269-70

REquesting Permission

Schimmelpenning syndrome with didymosisaplasticosebacea in an infant