CME EDUCATIONAL OBJECTIVES: 1.Identify the clinical features of aplasia cutis congenita (ACC).2.Understand the differential diagnosis of ACC.3.Recognize features of concern for underlying associations of ACC. A 6-week-old girl presented to the dermatology clinic for evaluation of a scalp lesion. She was born full-term by vaginal delivery to a 27-year-old healthy mother with normal prenatal labs. The delivery was complicated by prolonged rupture of membranes and a scalp electrode was placed at hour 20 of labor. Forceps or other instrumentation were not used during delivery. In the general care nursery, the infant was noted to have a scalp lesion. No bleeding or drainage was ever noted from the area. The lesion remained unchanged since birth with no intermittent enlargement noted. Review of systems was unremarkable. Family history was noncontributory.