CUTIS VERTICIS GYRATA ( BRAIN-LIKE SCALP)

CUTIS VERTICIS GYRATA is a superficial medical condition usually associated with thickening of the scalp. Sufferers show visible folds, ridges or creases on the surface of the top of the scalp. The number of folds can vary from 2 to roughly 10 and are typically soft and spongy. These folds cannot be corrected with pressure. The condition typically affects the central and rear regions of the scalp, but sometimes can involve the entire scalp.

CLASSIFICATION

Primary essential cutis verticis gyrata: for cases in which no other abnormality was found (rare)

 Primary nonessential:  which can be associated with mental deficiency, cerebral palsy, epilepsy, schizophrenia, cranial abnormalities (microcephaly), deafness, ophthalmologic abnormalities (cataract, strabismus, blindness, retinitis pigmentosa), or a combination of these.

Secondary cases of cutis verticis gyrata are associated with the following underlying disease

• Melanocytic nevi or hamartomas
• Neurofibroma
• Fibroma
• Dermatofibroma
• Cylindroma
• Nevus lipomatosus
• Connective tissue nevus
• Acromegaly
• Diabetes mellitus
• Autosomal dominant insulin-resistant syndrome
• Myxedema
• Graves disease
• Cretinism
• Amyloidosis

CAUSES

In the primary essential form, the etiology is not known, and, though most of the cases seem sporadic, autosomal recessive and autosomal dominant inheritance with variable expression have been described. In the primary nonessential form, the pathogenesis (beside the genetic determination) may have an endocrinologic basis.

Cutis verticis gyrata mainly occurs in males, after puberty, and it may disappear after castration.This may be due to increased peripheral use of testosterone, which was further supported by the results of the study in which the free testosterone level was reduced in patients with primary cutis verticis gyrata compared with controls. Male predominance may also suggest an X-linked inheritance. An association with the fragile X syndrome or other fragile sites on chromosomes 9, 10, and 12, and, in a single case, breaks at bands 3p14 and 16q23, has been reported. In the secondary form, the etiology depends on the underlying process (eg, inflammatory, neoplastic). Lymphedema is a postulated cause of cutis verticis gyrata in Turner and Noonan syndromes.

TREATMENT

Properly establishing the diagnosis is very important. Separately exclude or treat any underlying process. 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.

In primary cutis verticis gyrata, surgical resection of the lesions is usually requested for psychological or esthetic reasons

SOURCE: WIKIPEDIA
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