Cutis verticis gyrata is a medical condition usually associated with thickening of the

scalp The scalp is the anatomical area bordered by the human face at the front, and by the neck at the sides and back. Structure The scalp is usually described as having five layers, which can conveniently be remembered as a mnemonic: * S: The ski ...

. The condition is identified by excessive thickening of the soft tissues of the scalp and characterized by ridges and furrows, which give the scalp a cerebriform appearance. Clinically, the ridges are hard and cannot be flattened on applying pressure. Patients show visible folds, ridges or creases on the surface of the top of the scalp. The number of folds can vary from two to roughly ten and are typically soft and spongy. The condition typically affects the central and rear regions of the scalp, but sometimes can involve the entire scalp. Hair loss can occur over time where the scalp thickens, though hair within any furrows remains normal. Thus far, due to the (apparent) rarity of the condition, limited research exists and causes are as yet undetermined. What is known, is that the condition is not exclusively congenital. The condition was first reported by

Jean-Louis-Marc Alibert Jean-Louis-Marc Alibert (2 May 1768 – 4 November 1837) was a French dermatologist born in Villefranche-de-Rouergue, Aveyron. He was a pioneer of dermatology. Life and work Originally planning to enter the priesthood, Alibert did not begin stu ...

in 1837, who called it ''cutis sulcata''. A clinical description of the condition was provided by Robert in 1843 and it was named by

Paul Gerson Unna Paul Gerson Unna, (September 8, 1850, Hamburg – January 29, 1929, Hamburg) was a German physician specialized in dermatology and one of the pioneers in dermatopathology. Biography Paul Unna was the son of Moritz Adolph Unna, a physician from H ...

in 1907.Unna PG. Cutis verticis gyrata. Monatschr Prakt Derm. 1907. 45:227-33. It has also been called ''Robert-Unna syndrome'', ''bulldog scalp'', ''corrugated skin'', ''cutis verticis plicata'', and ''pachydermia verticis gyrata''.

Cause

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

Diagnosis

There is no clinical diagnosis for CVG as cases are rarely seen and are often comorbid with other conditions.

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 in unknown. It has no other associated abnormalities. This occurs mainly in men, with a male:female ratio of 5:1 or 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 Growth hormone (GH) or somatotropin, also known as human growth hormone (hGH or HGH) in its human form, is a peptide hormone that stimulates growth, cell reproduction, and cell regeneration in humans and other animals. It is thus important in h ...

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 CJC-1295, also known as DAC:GRF (short for drug affinity complex:growth hormone-releasing factor), is a synthetic analogue of growth hormone-releasing hormone (GHRH) (also known as ''growth hormone-releasing factor'' (''GRF'')) and a growth hormo ...

). 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)).. More recently, two published medical journals appear to show

Hyaluronidase Hyaluronidases are a family of enzymes that catalyse the degradation of hyaluronic acid (HA). Karl Meyer classified these enzymes in 1971, into three distinct groups, a scheme based on the enzyme reaction products. The three main types of hyal ...

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 with promising results.

References

Notes Bibliography *

External links