title: Aplasia cutis congenita in a setting of fetus papyraceus associated with small fetal abdominal circumference and high alpha-fetoprotein and amniotic acetylcholinesterase.
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.
authors.affiliation: Department of Dermatology, Beth Israel Medical Center, New York, New York; Department of Dermatology, St. Luke's-Roosevelt Hospital Center, New York, New York.
authors.forename: Joni M
authors.initials: JM
authors.lastname: Mazza
authors.forename: Janice F
authors.initials: JF
authors.lastname: Klein
authors.forename: Kurt
authors.initials: K
authors.lastname: Christopher
authors.forename: Nanette B
authors.initials: NB
authors.lastname: Silverberg
mesh_terms: D000005:Abdomen / Q000002:abnormalities*; D000110:Acetylcholinesterase / Q000378:metabolism*; D000653:Amniotic Fluid / Q000201:enzymology*; D004200:Diseases in Twins / Q000473:pathology*; D004476:Ectodermal Dysplasia / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D005313:Fetal Death; D005317:Fetal Growth Retardation; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D012871:Skin Diseases / Q000473:pathology; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D000509:alpha-Fetoproteins; D000110:Acetylcholinesterase