We describe a 4-year-old Hispanic boy with a dermal pit and an overlying macular vascular malformation in the lumbosacral area. Magnetic resonance 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 occult spinal dysraphisms are reviewed.

ongenital midline cutaneous paraspinal lesions, mostly located in the lumbosacral areas, are widely recognized as markers of occult spinal dysraphism. Diastematomyelia, or a split spinal cord, is an unusual congenital spinal abnormality in which the spinal cord is divided into 2 columns by a fibrous, cartilaginous, or bony septum. In most cases, lesions are located on the lower thoracic and upp...