Which of the following lesions is not one of the cutaneous stigmata of occult spinal dysraphism?

E. Café-au-lait spot over the thoracolumbar spine.

DISCUSSION: Café-au-lait spots are not a feature of spina bifida occulta. The other four skin features all may be associated with significant intradural pathology and warrant further investigation, most commonly with magnetic resonance imaging (MRI). A dermal sinus tract that overlies the coccyx is a pilonidal sinus and is not likely to be associated with intradural pathology.