Ann Dermatol.  1995 Oct;7(4):346-349. 10.5021/ad.1995.7.4.346.

A Case of Tethered Cord Syndrome Manifested with a Neurotrophic Ulcer

• Kim DY
• Lee SC
• Won YH
• Chun IK

• KMID: 2361367
• DOI: http://doi.org/10.5021/ad.1995.7.4.346

Abstract

We report herein a case of tethered cord syndrome with recurrent ulcerations of the skin in a 17-year-old girl. The patient presented an asymptomatic punched-out deep ulcer on the right buttock and right heel. The lesions were noticed as bullae on the sites, which developed into ulceration. At birth, a reddish nodule was noted on the lower back, which was excised when she was 3 years old at a private clinic. Neurological examination revealed hypoesthesia below the LS dermatome. We suspected a simple neurotrophic ulcer which was treated with zinc oxide dressing and oral antibiotics. 1 month later, the ulcers had healed, but tense bullae had developed on the same right buttock. Spina bifida with intraspinal lipoma was revealed by plain X-ray film and magnetic resonance imgaing. Tethered cord syndrome was diagnosed, and treated with a surgical excision of the lipoma, and repair of the dura. This is a vary rare etiology of a neurotrophic ulcer due to a central nervous system disease, and is the first reported case in the Korean dermatologic literature.

Keyword

Neurotrophic ulcer; Tethered cord syndrome

MeSH Terms

Adolescent
Anti-Bacterial Agents
Bandages
Buttocks
Central Nervous System
Female
Heel
Humans
Hypesthesia
Lipoma
Neural Tube Defects*
Neurologic Examination
Parturition
Skin
Spinal Dysraphism
Transcutaneous Electric Nerve Stimulation
Ulcer*
X-Ray Film
Zinc Oxide
Anti-Bacterial Agents
Zinc Oxide