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November 4, 1974

Congenital Annular Bands

Author Affiliations

Veterans Administration Center Wilmington, Del

JAMA. 1974;230(5):670-671. doi:10.1001/jama.1974.03240050018009

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To the Editor.—  In the article by Drs. Alan K. Izumi and Harry L. Arnold, Jr. (229:1208, 1974), the authors offer the evidence that these annular bands represent a congenital collagen dysplasia rather than scars. This should be reevaluated in the light of other articles. One of the more recent is "Congenital Constricting Bands and Congenital Amputations of the Fingers" by Joseph H. Field, MD, and Daniel O. Krag, MD (J Bone Joint Surg 55A:1035, 1973). This article shows rather conclusive evidence that congenital constricting bands can be traced to a tear in the amnion occurring at a strategic time in embryonic development. When this occurs, strands from the amnion and chorion wrap themselves around fetal parts. Two cases in the article, which presented gross and microscopic studies of the placentas of these cases, show missing amnion and the expected changes in the chorion.