فهرست مطالب alireza yahyaei shahandashti

Aplasia cutis congenita (ACC) is a rare condition regarded as a congenital absence of the epidermis, dermis, and in some cases, subcutaneous tissues in the newborn. The pathogenic mechanism is unclear, although the condition has been described as a result of the disrupted development or degeneration of skin in utero. ACC may be observed with fetus papyraceous (FP).

We report a case of an 8-hour-old newborn female with bilateral symmetrically distributed, stellate type of truncal ACC at birth. She was the survivor twin as the other fetus died at 13wk+3d gestation. This condition describes ACC with FP. Physical examination showed otherwise normal and managed with no other congenital abnormalities. The newborn was treated with antibacterial ointment and antibiotics, and lesions resolved spontaneously within 5 days, leaving scars.

This report explained a newborn with type V cutis aplasia congentia in whom the detection was approved based on the revision of antenatal history and clinical features. The protocol outcome revealed that the topical and systemic antibiotic and washing with normal saline could be an effective treatment for the healing of ACC lesions. Follow-up after 3 months indicated that the skin lesion completely healed, leaving a very small atrophic scar, and no further lesion management was required.

Chickenpox is a very contagious viral disease that caused by varicella-zoster virus, which appears in the first week of life secondary to transplacental transmission of infection from the affected mother. When mother catches the disease five days before and up to two days after the delivery, the chance of varicella in neonate in first week of life is 17%. A generalized papulovesicular lesion is the most common clinical feature. Respiratory involvement may lead to giant cell pneumonia and respiratory failure. The mortality rate is up to 30% in the case of no treatment, often due to pneumonia. Treatment includes hospitalization, isolation and administration of intravenous acyclovir. The aim of this case report is to introduce the exogenous surfactant replacement therapy after intubation and mechanical ventilation for respiratory failure in neonatal chickenpox pneumonia and respiratory distress. A seven-day-old neonate boy was admitted to the Neonatal Intensive Care Unit at Amirkola Children’s Hospital, Babol, north of Iran, with generalized papulovesicular lesions and respiratory distress. His mother has had a history of Varicella 4 days before delivery. He was isolated and given supportive care, intravenous acyclovir and antibiotics. On the second day, he was intubated and connected to mechanical ventilator due to severe pneumonia and respiratory failure. Because of sever pulmonary involvement evidenced by Chest X-Ray and high ventilators set-up requirement, intratracheal surfactant was administered in two doses separated by 12 hours. He was discharged after 14 days without any complication with good general condition. Exogenous surfactant replacement therapy can be useful as an adjunctive therapy for the treatment of respiratory failure due to neonatal chickenpox.