Aplasia cutis is a very rare congenital anomaly characterized by the complete or partial absence of an area of skin and bone at birth. Although it most commonly affects the scalp, it can also occur on the face, trunk, and extremities. Aplasia cutis is associated etiologically with neural tube defects and incomplete closure of embryonic fusion lines; vascular insufficiency of the skin resulting from placental insufficiency; intrauterine infections; teratogenic factors; amniotic bands; and the development of chromosomal abnormalities.

A male infant weighing 2750 grams, with an APGAR score of 8, was delivered by cesarean section at 38 weeks’ gestation as the first live birth from the mother’s first pregnancy, at age 21. Evaluation revealed a well-defined aplasia cutis lesion of variable depth, consistent with an area of necrotic tissue, affecting approximately 40% of the parieto-occipital scalp.
Wound care was provided in the neonatal intensive care unit. The family was informed about the condition and psychosocial support was provided. Without any surgical intervention (debridement), the wound site was moistened with Polyhexanide-Poloxamer solution and left for 5 minutes, after which daily dressings were applied using Polyhexanide-Poloxamer gel on paraffin gauze. At the end of 18 days, epithelialization at the wound edges and a degree of reduction in wound size were observed. Subsequently, the dressing method was changed: the wound was first rinsed with Polyhexanide-Poloxamer solution and left for 5 minutes, then Polyhexanide-Poloxamer gel was applied and the wound was covered with a modern polyurethane-hydrocolloid wound dressing. During this period, dressings were applied every 4 days. At the assessment on day 36, the necrotic areas had completely disappeared, most of the wound had epithelialized, and healing was found to be stable.

Treatment of aplasia cutis varies according to the size and location of the lesion. Conservative treatment should be preferred before surgical treatment. With conservative treatment, the skin generally epithelializes gradually over several weeks, leaving an alopecic and atrophic scar. Sensitivity was noted in the healed skin area, and the parents were advised to apply emollient creams to this area. In addition, involving the family in the process and addressing their information needs throughout are of considerable importance in accelerating healing. In a 2022 case report by Higgins, the wound was found to have healed with dressings without surgical intervention. Our case is consistent with the literature.