Sacral nevus flammeus simplex: The role of imaging

Neonates with midline lumbar, thoracic, or occipital cutaneous lesions shou ld be suspected of having spinal dysraphism and should undergo an imaging s tudy. The aim of the present study was to evaluate whether sacral nevus fla mmeus simplex (SNFS) in neonates is associated with spinal dysraphism, Duri ng a period of 6 months, we prospectively examined all neonates in our cent er for the presence of SNFS. Those affected were evaluated for associated a nomalies by physical and neurologic examination and ultrasound imaging of t he lumbosacral area. Twenty-eight of 3623 neonates (0.77%) were diagnosed a s having SNFS. In 64% of the SNFS patients, nevus flammeus simplex (NFS) wa s noted as well, Physical and neurologic examinations were unremarkable. Ul trasound imaging of the lumbosacral area was performed in 25 patients (89%) and revealed diastematomyelia in one. The results show that SNFS may const itute the only cutaneous sign of spinal dysraphism. In conclusion, we recom mend that neonates with SNFS be investigated for occult spinal dysraphism.