Abstract
Cobb syndrome is rare in the international literature. It is characterized by segmental cutaneous and spinal vascular malformations within the same metamere. We present the first documented case in Peru. We present a case of a patient with paraparesia and congenital violaceous-red cutaneous patch in a metameric distribution. Lumbar spine magnetic resonance imaging revealed spinal canal involvement at T8 level, prompting decompressive laminectomy and lesion biopsy. Histopathological analysis demonstrated dermal capillary proliferation and mild polymorphonuclear infiltrate. Adjuvant treatment was initiated. At 9-month follow-up, significant improvement in bilateral lower limb motor strength was noted. The identification of segmental lesions, combined with clinical correlation and biopsy-confirmed spinal vascular malformation, was critical in differentiating Cobb syndrome from other neurocutaneous disorders. This case underscores the importance of interdisciplinary collaboration in diagnosing and managing rare neurocutaneous syndromes.