Aplasia Cutis Congenita in a Setting of Fetus Papyraceus Associated with Small Fetal Abdominal Circumference and High Alpha-Fetoprotein and Amniotic Acetylcholinesterase

Authors

  • Joni M. Mazza M.D.,

    Corresponding author
    1. Department of Dermatology, Beth Israel Medical Center, New York, New York
    2. Department of Dermatology, St. Luke's-Roosevelt Hospital Center, New York, New York
    • Address correspondence to Joni Mazza, M.D., Dermatology Resident, PGY-3, St. Luke's-Roosevelt Hospital Center, Suite 11B, 1090 Amsterdam Ave., New York, NY 10025, or e-mail: jmazza17@gmail.com.

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  • Janice F. Klein M.D.,

    1. Department of Pediatrics, St. Luke's-Roosevelt Hospital Center, New York, New York
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  • Kurt Christopher M.D.,

    1. Department of Obstetrics and Gynecology, St. Luke's-Roosevelt Hospital Center, New York, New York
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  • Nanette B. Silverberg M.D.

    1. Department of Dermatology, Beth Israel Medical Center, New York, New York
    2. Department of Dermatology, St. Luke's-Roosevelt Hospital Center, New York, New York
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Abstract

Fetus papyraceus is the fetal death of one or more fetuses in a multiparous pregnancy. The surviving infants can experience extensive aplasia cutis in an H-shaped distribution over the flanks and abdomen as a consequence of the loss of their fetal sibling. We report the case of a monochorionic, diamniotic pregnancy complicated by a single fetal death at 13 weeks of gestational age. Aplasia cutis of the surviving twin was suggested in utero by three criteria: high amniotic and maternal alpha-fetoprotein, detectable acetylcholinesterase, and small abdominal circumference on prenatal ultrasound. This constellation of findings in the setting of fetus papyraceus can be an indicator of aplasia cutis in the surviving fetus.

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