Cutis verticis gyrata (CVG) is a distinctive, rare scalp condition that presents as visible folds and furrows on the head. These formations create an appearance similar to the convolutions of the brain’s surface. While often physically benign, its unique presentation makes it a notable dermatological characteristic.
What is Cutis Verticis Gyrata?
Cutis verticis gyrata is characterized by thickened, convoluted folds and deep furrows on the scalp. The condition typically affects the central and back regions of the scalp, including the vertex and occiput, but can sometimes involve the entire scalp.
The number of folds can vary, ranging from two to more than ten, and they are generally soft and spongy to the touch. While the skin color within these folds usually remains unaffected, the condition can become more noticeable if there is hair loss over the affected areas. CVG is a rare disorder, occurring more frequently in males than females.
How and Why it Develops
Cutis verticis gyrata is categorized into primary and secondary forms, based on its underlying cause. Primary CVG occurs without an identifiable underlying disease. It is further divided into primary essential, where no other abnormalities are present, and primary non-essential, which is associated with other conditions. The exact cause of primary essential CVG remains unknown, though genetic and hormonal factors are suspected due to its typical onset after puberty and male predominance. Primary non-essential CVG, also known as cutis verticis gyrata-intellectual disability (CVG-ID), is linked to certain genetic syndromes and developmental issues.
Secondary CVG develops from various other health conditions that lead to changes in the scalp’s structure. These can include inflammatory skin conditions such as eczema, psoriasis, and folliculitis. Systemic diseases like acromegaly (excess growth hormone), amyloidosis, and certain endocrine disorders can also contribute to its development. Additionally, secondary CVG may arise from benign or malignant tumors, birthmarks, or nevi on the scalp.
Identifying the Condition and Related Health Concerns
Diagnosing cutis verticis gyrata is primarily a clinical process, based on the characteristic appearance of the scalp’s folds and furrows. A healthcare provider will typically conduct a thorough physical examination and review the patient’s medical history. While imaging tests like MRI or laboratory tests are not usually needed to diagnose CVG itself, they become important tools to investigate potential underlying causes or associated conditions, particularly in cases of secondary or primary non-essential CVG.
For some individuals, CVG is an isolated finding, known as primary essential CVG, with no other health issues. However, for others, especially those with primary non-essential or secondary forms, CVG can be a marker for broader health concerns. These can include neurological disorders such as intellectual disability, epilepsy, and cerebral palsy. Ocular abnormalities like cataracts, strabismus, and even blindness have also been reported. In some instances, psychiatric conditions may also be associated with the condition. The presence of CVG prompts a comprehensive evaluation to identify and address any co-occurring medical conditions.
Approaches to Treatment and Care
Treatment for the scalp folds of cutis verticis gyrata is often not medically necessary, especially if the condition is isolated and does not cause discomfort. Intervention typically involves cosmetic concerns due to the condition’s distinct appearance or the need to address any underlying associated medical conditions. Good scalp hygiene is important for all individuals with CVG to prevent the accumulation of secretions and debris within the furrows, which can lead to irritation or infection.
For cosmetic improvement, surgical options are available to reduce or remove the excess skin folds. These procedures may include scalp reduction or excision of the affected tissue, aiming to smooth the scalp’s surface. The extent and type of surgical intervention depend on the number and depth of the folds. Beyond the scalp itself, managing any associated systemic or neurological conditions is an important aspect of overall care.