Lumbar skin abnormality in a baby: is it always a banal lesion?

Occult spinal dysraphism refers to congenital anomalies which are characterized by an incomplete fusion of the neural tube without exposure of the lesion to the outside. The main clinical syndrome is the tethered cord syndrome that leads to important neurological manifestations with permanent deterioration. Skin and nervous system have a common ectodermal origin so combined malformations of both are common. Many skin lesions are associated with occult spinal dysraphism, on several occasions, they are the only clue to suspect this pathology. A magnetic resonance is the fundamental method to reach a certain diagnosis. Greater awareness of this pathology and a better recognition of skin lesions by professionals would lead to an early diagnosis and an individualized management in order to avoid neurological deficits. We report a case of early diagnosis and review the medic literature.