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Congenital Cutaneous Defects as Complications in Surviving Co-twins
Aplasia Cutis Congenita and Neonatal Volkmann Ischemic Contracture of the Forearm
Christine Léauté-Labrèze, MD;
Florence Depaire-Duclos, MD;
Jean Sarlangue, MD;
Daniel Fontan, MD;
Boris Sandler, MD;
Jean Maleville, MD;
Alain Taïeb, MD
Arch Dermatol. 1998;134:1121-1124.
Background During twin pregnancies, several complications may result in the death of a co-twin depending on the date of death. We describe herein 2 infant survivors of monozygotic twin pairs with 2 distinct possible complications: aplasia cutis congenita and Volkmann ischemic contracture.
Observations One infant had extensive aplasia cutis congenita with an associated monozygotic co-twin who died at 3 months of gestation, and the other child had a localized arm defect due to Volkmann ischemic contracture and brain damage, with a co-twin who died at approximately 6 weeks of gestation.
Conclusions Congenital cutaneous defects may result in the death of a co-twin. The most common of these defects is aplasia cutis congenita associated with a fetus papyraceus or a dead fetus related to ischemic/thrombotic events in the placenta and fetus. Volkmann ischemic contracture is rare in the newborn but can cause neonatal cutaneous defects. The cause of Volkmann ischemic contracture in newborns is unknown; however, our second observation suggests the possible role of a dead fetus.
From the Pediatric Dermatology Unit (Drs Léauté-Labrèze, Depaire-Duclos, Maleville, and Taïeb), Neonatology Service (Drs Sarlangue and Sandler), and the Pediatric Neurology Unit (Dr Fontan), Hôpital Pellegrin-Enfants, Bordeaux, France.
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Aplasia cutis in association with a triplet pregnancy and fetus papyraceus
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Congenital Cutaneous Defects in Co-Twins
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