We describe a 4-year-old Hispanic boy with a dermal pit and an overlyi
ng macular vascular malformation in the lumbosacral area Magnetic reso
nance imaging of the region revealed an intraspinal lesion at L1-L2. A
fibrous tract was excised. A benign lipoma intrinsic to the roots of
the cauda equina was noted at surgery. The cutaneous stigmata of occul
t spinal dysraphisms are reviewed.