CONGENITAL CUTANEOUS DEFECTS AS COMPLICATIONS IN SURVIVING CO-TWINS -APLASIA-CUTIS-CONGENITA AND NEONATAL VOLKMANN ISCHEMIC CONTRACTURE OFTHE FOREARM

Background: During twin pregnancies, several complications may result in the death of a co-twin depending on the date of death. We describe herein 2 infant survivors of monozygotic twin pairs with 2 distinct po ssible complications: aplasia cutis congenita and Volkmann ischemic co ntracture. Observations: One infant had extensive aplasia cutis congen ita with an associated monozygotic co-twin who died at 3 months of ges tation, and the other child had a localized arm defect due to Volkmann ischemic contracture and brain damage, with a co-twin who died at app roximately 6 weeks of gestation. Conclusions: Congenital cutaneous def ects may result in the death of a co-twin. The most common of these de fects is aplasia cutis congenita associated with a fetus papyraceus or a dead fetus related to ischemic/thrombotic events in the placenta an d fetus. Volkmann ischemic contracture is rare in the newborn but can cause neonatal cutaneous defects. The cause of Volkmann ischemic contr acture in newborns is unknown; however, our second observation suggest s the possible role of a dead fetus.