Cutis Verticis Gyrata Clinical Presentation

Updated: May 09, 2018
  • Author: Malgorzata D Skibinska, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

In primary cutis verticis gyrata, skin plaques develop after puberty, usually in the vertex and occipital region. In secondary cutis verticis gyrata, skin plaques can be present at birth. The skin gradually becomes thicker, and folds and furrows are formed.

No other symptoms are usually present; however, pain was observed in cases with cutis verticis gyrata due to intradermal nevus and in traction alopecia. The progression of changes is visible.

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Physical Examination

In the primary form, only the scalp is involved. Cutis verticis gyrata typically affects the vertex and occipital region, but some forms can involve the entire scalp. Folds are soft and spongy and cannot be corrected by pressure or traction. In primary cutis verticis gyrata, folds are usually symmetric; in secondary cutis verticis gyrata, folds are asymmetric.

In most cases, the direction of the folds is anterior to posterior, but it may be transverse in the occipital region. The number of folds varies from 2-12, although some atypical cases with 1 fold have been described. The skin color is unchanged. The hair over the folds may be sparse but normal in the furrows. Maceration and an unpleasant smell may be present in patients with secondary infections in the furrows.

See the image below.

Cutis verticis gyrata. Courtesy of DermNet New Zea Cutis verticis gyrata. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/assets/Uploads/dermal-infiltrative/cvg2.jpg).
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