Topical Gentamicin in the Management of Bart Syndrome: A Case Report

Bart syndrome is a rare congenital disorder characterized by localized absence of skin, epidermolysis bullosa (EB), and nail abnormalities. We report the case of a female newborn presenting with congenital absence of skin on both feet, associated to multiple blisters in friction-prone areas and paronychia. Despite these findings, she remained clinically stable, was feeding normally, and exhibited no gastrointestinal symptoms. Based on the association of aplasia cutis and epidermolysis bullosa, a diagnosis of Bart syndrome was clinically suspected. The patient was treated with topical gentamicin 0.5% diluted in petroleum jelly, applied twice weekly, combined with a non-adhesive dressing. Clinical improvement was observed, with complete healing of the perineal lesions within three months and significant regression of limb involvement. Although spontaneous re-epithelialization is part of the natural course of the disease, the rapid and sustained clinical evolution raises the possibility of a beneficial effect of gentamicin. To the best of our knowledge, similar responses in this specific context have rarely been reported. Larger studies are required to confirm efficacy, define optimal treatment protocols, and evaluate long-term safety.