Description

Pregnancy with an intrauterine device (IUD) in situ occurs at a rate of 0.1 per 100 woman-years.1 Most frequently, the IUD is removed, because it may cause early abortion. Currently, an IUD in situ during pregnancy is not known to cause any other harm to the fetus.2

We present the case of a 10-year-old boy who had been born after pregnancy with an IUD in situ. The pregnancy had otherwise been uneventful, and he was born after vaginal delivery. At birth, it was observed that the IUD was located behind the right ear of the infant. Since birth, he had suffered from an uncharacteristic skin mark behind his right ear, where the IUD had been located. The skin lesion itched and irritated and, at times, the boy experienced a worsening of the condition, with minor bleeding, exudation and infection. When worsening occurred, he received topical treatment with corticosteroids or antibiotics. At the age of 10 years, the lesion was 3 cm long and 4 mm wide (figure 1). At this point, surgical resection was offered, accepted and performed (figure 2). The postoperative phase was without complications. Pathological examination showed a nevus sebaceous, which is an epidermal hyperplasia, caused by growth of excess sebaceous glands. The nevus is often present at birth, and thought to come from a small defect in fetal ectoderm.3

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Figure 1

Nevus sebaceous behind the right ear.

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Figure 2

The nevus sebaceous was surgically resected.

The present case shows that pregnancy with an IUD in situ may cause skin lesions at the site where the IUD is located on the skin of the fetus. Surgical resection is the definitive treatment for these lesions, also because there is a small risk of malignant change after puberty.