Cutis verticis gyrata

Cause

At this time, causes are unknown, but it is believed to not be congenital.{{cite journal

Conditions and syndromes

CVG is a feature of several conditions:

• Acromegaloid phenotype with cutis verticis gyrata and corneal leukoma
• Beare-Stevenson cutis gyrata syndrome
• Cutis verticis gyrata and intellectual disability
• Cutis verticis gyrata, thyroid aplasia, and intellectual disability
• Hypertrophic osteoarthropathy, primary, autosomal dominant
• NDE1-related microhydranencephaly
• Necrotizing encephalomyelopathy, subacute, of Leigh, adult

Diagnosis

The diagnosis of CVG is primarily clinical, based on the physical appearance of the scalp. Dermatological examination reveals the presence of thickened skin folds and furrows that are most commonly found on the vertex and occipital regions of the scalp. In some cases, additional tests may be conducted to rule out underlying conditions, especially for secondary CVG, including hormonal assays, imaging studies, or biopsy to assess the scalp's histological features.

Classifications

CVG is classified according to the presence, or lack of underlying cause. Studies suggest that CVG often occurs in individuals in a secondary form to other ailments. However, the condition can also be present on its own. CVG can be classified into two forms: 'primary' (essential and non-essential) and 'secondary'.

The classifications are: :*Primary essential :*Primary non-essential :*Secondary

Primary essential CVG is where the cause of the condition is unknown. It has no other associated abnormalities. This occurs mainly in men, with a male:female ratio of between 5:1 and 6:1, and develops during or soon after puberty. Because of the slow progression of the condition, which usually occurs without symptom, it often passes unnoticed in the early stage.

Primary non-essential CVG can be associated with neuropsychiatric disorders including cerebral palsy, epilepsy, seizures, and ophthalmologic abnormalities, most commonly cataracts.

Secondary CVG occurs as a consequence of a number of diseases or drugs that produce changes in scalp structure. These include: acromegaly (excessive growth hormone levels due to pituitary gland tumours), and theoretically, the use of growth hormone itself or the use of drugs that mimic the effect of growth hormone (such as GHRP-6 and CJC-1295). It may also arise in association with melanocytic naevi (moles), birthmarks (including connective tissue naevi, fibromas and naevus lipomatosus), and inflammatory processes (e.g. eczema, psoriasis, Darier disease, folliculitis, impetigo, atopic dermatitis, acne).

Treatment

Options for medical treatment for this condition have been limited to plastic surgery with excision of the folds by means of scalp reduction/surgical resection. Scalp subcision has also been suggested as a treatment. Additional suggestions also include injections of a dermal filler (e.g. (poly-L-lactic acid)).

Two published medical journals appear to show Hyaluronidase injections (Hyaluronidase is an enzyme used to dissolve hyaluronic acid which is a component of our skin that contributes to its thickness) as a possible treatment.

References

Notes

Bibliography

References

1. (2005). "Andrews' Diseases of the Skin: Clinical Dermatology". Saunders.
2. (2007). "Dermatology: 2-Volume Set". Mosby.
3. (July 2006). "Primary essential cutis verticis gyrata in an adult female patient: a case report". The Journal of Dermatology.
4. (2016). "Cutis verticis gyrata in a patient with multiple basal cell carcinomas; case presentation and review of the literature". Journal of Mind and Medical Sciences.
5. (February 2019). "Cutis Verticis Gyrata". [[Medscape]].
6. (1907). "Cutis verticis gyrata". Monatshefte für praktische Dermatologie.
7. Levine, Norman. (2004). "Dermatology Therapy A-Z Essentials". Springer.
8. "Cutis gyrata of scalp (Concept Id: C0263417)".
9. (2009). "Primary essential cutis verticis gyrata – a case report". Journal of Plastic, Reconstructive & Aesthetic Surgery.
10. (October 2001). "MRI in essential primary cutis verticis gyrata". Neuroradiology.
11. (March 2009). "Using novel subcision technique for the treatment of primary essential cutis verticis gyrata". International Journal of Dermatology.
12. "Unusual and rare complication described in San Francisco {{!}} CATIE – Canada's source for HIV and hepatitis C information".
13. (2021). "Hyaloronidase as a Treatment for Cutis Verticis Gyrata". Plastic Surgery Case Studies.
14. (5 January 2019). "Cutis Verticis Gyrata Improved with Injected Hyaluronidase Treatments". Dermatology Archives.