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Spine
Diagnosis
Congenital
Abnormalities of Neurulation
Dorsal Dermal Sinus
Dorsal Dermal Sinus
Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Dermal sinus tract (DST)

              • Definitions

                • Midline/paramedian stratified squamous epithelial-lined sinus tract extending inward from skin surface for variable distance

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Nonvascular Interventions

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Lee JY et al: Congenital dermal sinus and limited dorsal myeloschisis: "spectrum disorders" of incomplete dysjuction between cutaneous and neural ectoderms. Neurosurgery. 84(2):428-34, 2019
                                                2. Prasad GL et al: Spinal intramedullary abscess secondary to dermal sinus in children. Eur J Pediatr Surg. 29(3):229-38, 2019
                                                3. Lee SM et al: Limited dorsal myeloschisis and congenital dermal sinus: comparison of clinical and MR imaging features. AJNR Am J Neuroradiol. 38(1):176-82, 2017
                                                4. Vankipuram S et al: Spinal cord abscess secondary to infected dorsal dermal sinus in an infant: uncommon presentation of a known entity. BMJ Case Rep. 2017, 2017
                                                5. Singh I et al: Spinal dorsal dermal sinus tract: an experience of 21 cases. Surg Neurol Int. 6(Suppl 17):S429-34, 2015
                                                6. Mishra SS et al: Thoracic congenital dermal sinus associated with intramedullary spinal dermoid cyst. J Pediatr Neurosci. 9(1):30-2, 2014
                                                7. Sahoo RK et al: Congenital dermal sinus in mid-dorsal spine with large intramedullary dermoid cyst in an 18-months-old child. J Pediatr Neurosci. 8(3):201-3, 2013
                                                8. Fallah A et al: Congenital dermal sinus and cyst in adulthood. Can J Neurol Sci. 36(1):114-6, 2009
                                                9. Lee CS et al: Spinal congenital dermal sinus with dual ostia. J Neurosurg Pediatr. 3(5):407-11, 2009
                                                10. Ranjan R et al: Cervical intradural extramedullary ependymal cyst associated with congenital dermal sinus: a case report. Childs Nerv Syst. 25(9):1121-4, 2009
                                                11. Singh DK et al: The human tail: rare lesion with occult spinal dysraphism--a case report. J Pediatr Surg. 43(9):e41-3, 2008
                                                12. Guggisberg D et al: Skin markers of occult spinal dysraphism in children: a review of 54 cases. Arch Dermatol. 2004 Sep;140(9):1109-15. Review. Erratum in: Arch Dermatol. 141(4):425, 2005
                                                13. Tubbs RS et al: Isolated flat capillary midline lumbosacral hemangiomas as indicators of occult spinal dysraphism. J Neurosurg. 100(2):86-9, 2004
                                                14. Pacheco-Jacome E et al: Occult spinal dysraphism: evidence-based diagnosis and treatment. Neuroimaging Clin N Am. 13(2):327-34, xii, 2003
                                                15. Ackerman LL et al: Cervical and thoracic dermal sinus tracts. A case series and review of the literature. Pediatr Neurosurg. 37(3):137-47, 2002
                                                16. Aydin K et al: Thoracocervical dorsal dermal sinus associated with multiple vertebral body anomalies. Neuroradiology. 43(12):1084-6, 2001
                                                17. Lee JK et al: Cervical dermal sinus associated with dermoid cyst. Childs Nerv Syst. 17(8):491-3, 2001
                                                18. Shen WC et al: Dermal sinus with dermoid cyst in the upper cervical spine: case note. Neuroradiology. 42(1):51-3, 2000
                                                19. Unsinn KM et al: US of the spinal cord in newborns: spectrum of normal findings, variants, congenital anomalies, and acquired diseases. Radiographics. 20(4):923-38, 2000
                                                20. Chen CY et al: Dermoid cyst with dermal sinus tract complicated with spinal subdural abscess. Pediatr Neurol. 20(2):157-60, 1999
                                                21. Gibson PJ et al: Lumbosacral skin markers and identification of occult spinal dysraphism in neonates. Acta Paediatr. 84(2):208-9, 1995
                                                22. Kanev PM et al: Dermoids and dermal sinus tracts of the spine. Neurosurg Clin N Am. 6(2):359-66, 1995
                                                23. Avrahami E et al: Spina bifida occulta of S1 is not an innocent finding. Spine. 19(1):12-5, 1994
                                                24. Herman TE et al: Intergluteal dorsal dermal sinuses. The role of neonatal spinal sonography. Clin Pediatr (Phila). 32(10):627-8, 1993
                                                25. Barkovich AJ et al: MR evaluation of spinal dermal sinus tracts in children. AJNR Am J Neuroradiol. 12(1):123-9, 1991
                                                26. Haworth JC et al: Congenital dermal sinuses in children; their relation to pilonidal sinuses. Lancet. 269(6879):10-4, 1955
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Synonyms

                                                              • Dermal sinus tract (DST)

                                                            • Definitions

                                                              • Midline/paramedian stratified squamous epithelial-lined sinus tract extending inward from skin surface for variable distance

                                                            IMAGING

                                                            • General Features

                                                              • Radiographic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Ultrasonographic Findings

                                                                      • Nonvascular Interventions

                                                                        • Imaging Recommendations

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Lee JY et al: Congenital dermal sinus and limited dorsal myeloschisis: "spectrum disorders" of incomplete dysjuction between cutaneous and neural ectoderms. Neurosurgery. 84(2):428-34, 2019
                                                                                              2. Prasad GL et al: Spinal intramedullary abscess secondary to dermal sinus in children. Eur J Pediatr Surg. 29(3):229-38, 2019
                                                                                              3. Lee SM et al: Limited dorsal myeloschisis and congenital dermal sinus: comparison of clinical and MR imaging features. AJNR Am J Neuroradiol. 38(1):176-82, 2017
                                                                                              4. Vankipuram S et al: Spinal cord abscess secondary to infected dorsal dermal sinus in an infant: uncommon presentation of a known entity. BMJ Case Rep. 2017, 2017
                                                                                              5. Singh I et al: Spinal dorsal dermal sinus tract: an experience of 21 cases. Surg Neurol Int. 6(Suppl 17):S429-34, 2015
                                                                                              6. Mishra SS et al: Thoracic congenital dermal sinus associated with intramedullary spinal dermoid cyst. J Pediatr Neurosci. 9(1):30-2, 2014
                                                                                              7. Sahoo RK et al: Congenital dermal sinus in mid-dorsal spine with large intramedullary dermoid cyst in an 18-months-old child. J Pediatr Neurosci. 8(3):201-3, 2013
                                                                                              8. Fallah A et al: Congenital dermal sinus and cyst in adulthood. Can J Neurol Sci. 36(1):114-6, 2009
                                                                                              9. Lee CS et al: Spinal congenital dermal sinus with dual ostia. J Neurosurg Pediatr. 3(5):407-11, 2009
                                                                                              10. Ranjan R et al: Cervical intradural extramedullary ependymal cyst associated with congenital dermal sinus: a case report. Childs Nerv Syst. 25(9):1121-4, 2009
                                                                                              11. Singh DK et al: The human tail: rare lesion with occult spinal dysraphism--a case report. J Pediatr Surg. 43(9):e41-3, 2008
                                                                                              12. Guggisberg D et al: Skin markers of occult spinal dysraphism in children: a review of 54 cases. Arch Dermatol. 2004 Sep;140(9):1109-15. Review. Erratum in: Arch Dermatol. 141(4):425, 2005
                                                                                              13. Tubbs RS et al: Isolated flat capillary midline lumbosacral hemangiomas as indicators of occult spinal dysraphism. J Neurosurg. 100(2):86-9, 2004
                                                                                              14. Pacheco-Jacome E et al: Occult spinal dysraphism: evidence-based diagnosis and treatment. Neuroimaging Clin N Am. 13(2):327-34, xii, 2003
                                                                                              15. Ackerman LL et al: Cervical and thoracic dermal sinus tracts. A case series and review of the literature. Pediatr Neurosurg. 37(3):137-47, 2002
                                                                                              16. Aydin K et al: Thoracocervical dorsal dermal sinus associated with multiple vertebral body anomalies. Neuroradiology. 43(12):1084-6, 2001
                                                                                              17. Lee JK et al: Cervical dermal sinus associated with dermoid cyst. Childs Nerv Syst. 17(8):491-3, 2001
                                                                                              18. Shen WC et al: Dermal sinus with dermoid cyst in the upper cervical spine: case note. Neuroradiology. 42(1):51-3, 2000
                                                                                              19. Unsinn KM et al: US of the spinal cord in newborns: spectrum of normal findings, variants, congenital anomalies, and acquired diseases. Radiographics. 20(4):923-38, 2000
                                                                                              20. Chen CY et al: Dermoid cyst with dermal sinus tract complicated with spinal subdural abscess. Pediatr Neurol. 20(2):157-60, 1999
                                                                                              21. Gibson PJ et al: Lumbosacral skin markers and identification of occult spinal dysraphism in neonates. Acta Paediatr. 84(2):208-9, 1995
                                                                                              22. Kanev PM et al: Dermoids and dermal sinus tracts of the spine. Neurosurg Clin N Am. 6(2):359-66, 1995
                                                                                              23. Avrahami E et al: Spina bifida occulta of S1 is not an innocent finding. Spine. 19(1):12-5, 1994
                                                                                              24. Herman TE et al: Intergluteal dorsal dermal sinuses. The role of neonatal spinal sonography. Clin Pediatr (Phila). 32(10):627-8, 1993
                                                                                              25. Barkovich AJ et al: MR evaluation of spinal dermal sinus tracts in children. AJNR Am J Neuroradiol. 12(1):123-9, 1991
                                                                                              26. Haworth JC et al: Congenital dermal sinuses in children; their relation to pilonidal sinuses. Lancet. 269(6879):10-4, 1955