Medical Care

Properly establishing the diagnosis is very important. Separately exclude or treat any underlying process. Improvement of cutis verticis gyrata with topical treatment of causal dermatitis has been reported.^[71]Primary essential cutis verticis gyrata is a cosmetic problem, but psychological repercussions are important.

Hygiene for folds and furrows is very important. In some patients, using medicated shampoos may be beneficial.

Surgical Care

In primary cutis verticis gyrata, surgical resection of the lesions is usually requested for psychological or esthetic reasons.^{[43, 44, 72, 73, 74, 75, 76]}

In cases of cerebriform intradermal nevus, early diagnosis, wide surgical excision, and plastic reconstruction should be always considered.^{[23, 24, 60]}

Consultations

Consult a surgeon to establish the possibility of surgical excision. Consider a consultation with a neurologist if any suspicion exists of an underlying neurologic process. Additionally, consider a consultation with an ophthalmologist if any suspicion exists of an underlying ophthalmologic abnormality.

Complications

Congenital nevus of the scalp, which may clinically produce cutis verticis gyrata, can be the site of malignant transformation and it can occur very early in life.^{[23, 24, 25, 58]}

Malignant melanoma occurs in up to 10% of patients with cerebriform melanocytic nevi; however, recent data suggest the rate of transformation may only be on the order of 4.5%.^{[23, 24, 62]}

Long-Term Monitoring

If the patient does not agree to any surgical treatment or this procedure is contraindicated, the patient should be seen every 3-6 months to estimate the progression of the lesions.

Patients with cerebriform melanocytic nevus require long-term clinical follow-up in order to detect malignant transformation.^{[24, 60]}

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Media Gallery

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

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Author

Malgorzata D Skibinska, MD, PhD Senior Lecturer, Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Łódź; Consultant Dermatologist and Allergist, Private Practice, Łódź, Poland

Malgorzata D Skibinska, MD, PhD is a member of the following medical societies: British Society of Allergy and Clinical Immunology, Polish Dermatological Society, Royal College of Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Camila K Janniger, MD Clinical Professor of Dermatology, Clinical Associate Professor of Pediatrics, Chief of Pediatric Dermatology, Rutgers New Jersey Medical School

Camila K Janniger, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Professor of Pediatrics, Professor of Medicine, Rutgers New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, Royal College of Physicians of Edinburgh, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Daniel J Hogan, MD Clinical Professor of Internal Medicine (Dermatology), Nova Southeastern University College of Osteopathic Medicine; Investigator, Hill Top Research, Florida Research Center

Daniel J Hogan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, Canadian Dermatology Association

Disclosure: Nothing to disclose.

Cutis Verticis Gyrata Treatment & Management

Medical Care

Surgical Care

Consultations

Complications

Long-Term Monitoring

References

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