Faun tail: a rare cutaneous marker of spinal dysraphism

A 10-year-old girl who was admitted to the urology department with complaints of urinary incontinence was referred to our dermatology outpatient clinic because of a congenital, circumscribed, hypertrichotic area on the lumbosacral region. Cutaneous examination revealed a circumscribed area of coarse, dark terminal hair measuring 25 x 15 cm overlying the lumbosacral area with normal underlying skin (Figure 1). There were erythematous macular lesions on the superior of the hairy area. The lesion had been present since birth, and no other family member had similar lesions. Her history revealed back pain and a long history of urinary incontinence. On neurologic examination, no motor weakness or sensory changes were observed. Babinski reflex was positive on the left. Magnetic resonance imaging (MRI) findings included diastematomyelia between T12 and L1 levels and slight flattening of lumbar lordosis (Figure 2). A diagnosis of faun tail with underlying spinal dysraphism was made. There was also urinary incontinence as late sequelae of spinal dysraphism.