Faun tail: a rare cutaneous stigma of spinal dysraphism

Abstract

A 13-year-old girl was referred to our dermatology outpatient clinic for the treatment of a congenital, circumscribed, hypertrichotic area on the lumbosacral region because it was cosmetically embarrassing. Dermatologic examination revealed a 25 × 15 cm circumscribed hypertrichotic area on the lumbosacral region. Coarse, dark, terminal hairs were observed, but the underlying skin was normal (Fig. 1). The lesion had been present since birth. Her history also revealed back pain, which developed by 3 years of age, and a long history of urinary incontinence. On neurologic examination, no motor weakness or sensory changes were observed.On orthopedic examination, minimal atrophy and 2 cm shortening of the right leg were detected, and the right foot was smaller than the left. There was an accentuation of lumbar lordosis. There was no history of a similar lesion in the family. There was no consanguinity in the relatives.Magnetic resonance imaging and computed tomography findings included diastematomyelia between T10 and L2 levels, minimal spina bifida at L2 -L3 levels, mild tethered cord, and a fat density mass at L1 level behind the left lamina. Complete blood cell count, erythrocyte sedimentation rate, and blood chemistry were within the normal ranges.The patient underwent lumbar laminectomy with excision of the lipoma and release of the tethered cord, and a type II diastematomyelia was detected at operation.A diagnosis of faun tail with underlying spinal dysraphism was made. There was also associated foot deformity and urinary incontinence as late sequelae of spinal dysraphism. The patient had been shaving the lesion periodically. We recommended laser epilation.

Faun Tail with Aplasia cutis congenita and Diastematomyelia

“…Faun tail is very rare, and it is not only an aesthetic problem because its presence may be one of the cutaneous stigmata of occult spinal dysraphism like other midline posterior cutaneous anomalies [1,2,4,6]. Our patient was the first case reported of faun tail associated with aplasia cutis congenita and telangiectatic nevus representing an occult diastematomyelia.…”

“…Abnormal lumbosacral hypertrichosis may present as Faun tail [4]. Here we present a girl patient with faun tail and diastematomyelia.…”

Faun Tail Nevus – A Case Report

“…A literature search revealed only few cases of this disorder [4][5][6]. The case is reported to highlight the importance of a thorough clinical and radiological assessment in such apparently normal individuals [7] and those with a definitive neurological abnormality, with a neurocutaneous marker.…”

Neurosurgery and a small section from the Greek myth: the God Pan and Syrinx

“…It is also known as "Ambras syndrome" because paintings of the first recorded case and his family reside in a castle in Ambras, Austria [1]. Lumbosacral hypertrichosis may be occurring as a "faun tail" or a "silky down", a wide, often triangularshaped patch of hair measuring up to several inches in length and found in the lumbosacral region; it is frequently a sign for an underlying spinal dysraphism [6,7]. Dermatologic findings may be found in more than half of the spinal dysraphisms, and one-third of them may include hypertrichosis [20].…”

“…It may be seen as terminal hair termed as faun tail. In cases of spinal dysraphism, various neurologic and/or orthopedic deficits also may accompany this condition [6,7,19]. Spinal dysraphism is a term covering all kinds of developmental abnormalities occurring in the midline of the back, including the skin and vertebral bodies [19].…”