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Abstract:  We present two cases of neonates born with symmetric aplasia cutis congenita associated with intrauterine fetal demise of cotwins during the early second trimester. Fetus papyraceus resulting in aplasia cutis congenita is a rare association with many clinical presentations, including extratruncal symmetric lesions and small linear, arcuate, and triangular lesions when twin intrauterine demise occurs after the first trimester.