CASE REPORT The faun tail and the plastic surgeon Chacko Cyriac & Vipul Nanda & Atul Parashar & Ramesh K. Sharma Received: 15 March 2008 / Accepted: 16 April 2008 / Published online: 28 May 2008 # Springer-Verlag 2008 Abstract Congenital spinal abnormalities seen with spinal dysraphism, when not recognized and treated in a timely fashion, can cause devastating neurological deficits. These anomalies are often accompanied by cutaneous markers, e.g., faun tail. Early recognition of the association of these lesions with the underlying spinal anomalies will reduce the morbidity associated with this condition. At times, the management of the cutaneous marker will be of primary importance. A review of Roman mythology surrounding the name ascribed to this clinical condition is included. Keywords Spinal dysraphism . Faun tail . Diastematomyelia Introduction Spinal dysraphism refers to a group of congenital anomalies resulting from the defective fusion of the midline structures of the embryo’ s dorsal median region [1]. During embryo- genesis, skin and nerve tissues both develop from the ectoderm. Therefore, anomalies of both these tissues may occur simultaneously. Skin lesions commonly associated with this condition are often detected early and are considered indicative of the presence of an underlying spinal lesion. One such cutaneous marker is the faun tail. Case report A healthy 20-year-old girl was referred to the outpatient clinic with an abnormal tuft of hair in the lumbosacral area present since birth. There were no similar complaints in the family. On examination of the lumbosacral region, there was a circumscribed hypertrichotic area with coarse dark hair measuring 25×20 cm (Fig. 1). Neurological examina- tion revealed no motor or sensory deficits. Orthopedic examination showed the presence of scoliosis with a compensatory pelvic rotation. The vertebrae were palpated for any defects or abnormalities. None were detected. Imaging studies of the underlying spine, however, revealed multiple anomalies involving the cord as well as the bony elements. The roentgenogram showed spina bifida with a scoliotic deformity of the spine with the convexity to the left (Fig. 2). The magnetic resonance imaging (MRI) image of the spine revealed sagittal clefting of the cord from the L1 level with a reunion of the two hemicords at the L4 level (diastematomyelia). There was a spina bifida defect involving the lumbosacral spine. The spinal cord was tethered at S1 level. The overlying skin was intact (Fig. 3). A diagnosis of faun tail with underlying spinal dysraphism was made. The patient was asymptomatic for the past 20 years. Her reason for the consultation was only because her problem was aesthetically embarrassing. She had to get the lesion shaved regularly. We therefore advised serial excision of the lesion. This was accomplished in two stages (Figs. 4, 5, and 6). Discussion The spinal anomalies seen in spinal dysraphism include spina bifida, diastematomyelia, abnormal filum terminale Eur J Plast Surg (2008) 31:329–332 DOI 10.1007/s00238-008-0256-9 C. Cyriac : V. Nanda : A. Parashar (*) : R. K. Sharma Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India e-mail: atulparashar@hotmail.com