CONGENITAL DERMAL SINUSES

Abstract

Congenital dermal sinuses are dermal tubes which extend inward from the surface for varying distances and frequently connect the central nervous system or its coverings with the surface of the body. The inner end of the sinus may be expanded to form a dermoid or epidermoid cyst. They are the result of incomplete separation of the epithelial ectoderm from the neuroectoderm at the fourth week of fetal development. On examination, a small dimple or a pinpoint sinus may be found in the midline at any point from the occipital to the sacral regions, inclusive. The dimple or sinus opening may be surrounded by a hair, a pigmented area or a capillary hemangioma. Hair or sebaceous material may project from the small opening at the bottom of the dimple. Often a cordlike structure is palpated, extending inward from the opening. Local superficial or deep infection may be present around the site