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April 2018

Spinal Dysraphism Presenting as a Translucent Papule in a Man

Author Affiliations
  • 1Department of Dermatology, University of Connecticut School of Medicine, Farmington
  • 2Department of Dermatology, University of Rochester Medical Center, Rochester, New York
JAMA Dermatol. 2018;154(4):489-490. doi:10.1001/jamadermatol.2017.6188

Spinal dysraphisms are congenital defects of the dorsal midline structures with myriad cutaneous manifestations, including neural tissue involvement at the skin surface. Herein, we describe a man with a meningocele, an open type of spinal dysraphism, presenting as a translucent papule on the posterior midline neck.

A man in his 60s presented for a skin examination, during which a distinctive lesion was incidentally noted on his posterior neck. He reported that it had been present all his life without changes in appearance or symptoms. On 3 occasions, it had drained clear, odorless fluid, with the drainage resolving spontaneously, but he was otherwise asymptomatic. Physical examination revealed a 1-cm, dome-shaped, pedunculated papule arising from a depression on the inferior aspect of his posterior midline neck (Figure 1). The papule was translucent, soft, and compressible, with an overlying vascular surface.

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