We read with interest the article by Stone et al1 in the June 1994 issue of the Archives. They report two cases of rudimentary meningocele (type I or primary cutaneous meningioma2) that presented at birth with a prominent tuft of hair located on the scalp. The authors opine that primary cutaneous meningiomas are developmental defects similar to meningoceles. This has been the prevalent opinion in the literature, but we have described a patient with a congenital localized hypertrichosis on the left lumbar region that showed the histologic and immunohistochemical features of a primary cutaneous meningioma (with no connection to the central nervous system), making the meningocele mechanism unlikely.3 Theaker et al4 have suggested that these lesions represent the continued growth of meningeal cells, displaced with cutaneous nerves, within the perineural environment that normally supports the growth and development of a related cell type. A literature search
Peñas PF, Jones-Caballero M, García-Díez A. Cutaneous Heterotopic Meningeal Nodules. Arch Dermatol. 1995;131(6):731. doi:10.1001/archderm.1995.01690180111022
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