Cutis Verticis Gyrata Treatment & Management

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

Medical Care

Properly establishing the diagnosis is very important. Separately exclude or treat any underlying process (see Background). Improvement of cutis verticis gyrata with topical treatment of causal dermatitis has been reported. [68] 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.

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Surgical Care

In primary cutis verticis gyrata, surgical resection of the lesions is usually requested for psychological or esthetic reasons. [67, 39, 69, 70, 71, 72, 73]

In cases of cerebriform intradermal nevus, early diagnosis, wide surgical excision, and plastic reconstruction should be always considered. [21, 22, 55]

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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.

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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. [21, 22, 23, 54]

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%. [21, 22, 57]

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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. [22, 55]

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