From the Guidelines
Cutis verticis gyrata (CVG) is a rare skin condition that requires a thorough medical evaluation to determine its underlying cause, with treatment focusing on addressing any associated conditions, proper scalp hygiene, and potentially surgical correction for cosmetic concerns. The diagnosis of CVG involves a comprehensive medical history and physical examination to identify any underlying conditions that may be contributing to the development of the scalp folds and furrows.
- Primary CVG typically appears during puberty and affects males more frequently than females, with no underlying medical condition identified 1.
- Secondary CVG, on the other hand, may be associated with various medical conditions such as acromegaly, myxedema, inflammatory diseases, or certain medications, and its treatment depends on addressing the underlying cause. In terms of treatment,
- proper scalp hygiene is essential to prevent infection in the deep grooves, with patients advised to wash the scalp thoroughly and dry it completely to avoid bacterial or fungal growth.
- For secondary cases, treating the underlying condition may improve the appearance of the scalp.
- Surgical correction may be considered for cosmetic concerns, particularly in cases where the condition causes significant psychological distress due to its appearance. It is essential to note that CVG is generally a benign condition, but its appearance can cause psychological distress, highlighting the importance of medical evaluation and appropriate management to address any underlying conditions and improve the patient's quality of life.
From the Research
Diagnosis of Cutis Verticis Gyrata (CVG)
- CVG is a rare morphological condition of the scalp characterized by ridges and furrows resembling the surface of the brain 2.
- The condition can be classified into three forms: primary essential, primary non-essential, and secondary 3.
- Primary essential CVG occurs in the absence of underlying soft-tissue abnormalities and is often associated with neuropsychiatric disorders 2.
- Secondary CVG occurs as a result of a local inflammatory or neoplastic process of the scalp or a systemic illness that produces pathologic changes in the scalp structure 2.
Treatment Options for CVG
- The choice of treatment for CVG is surgical repair, which depends on the size and location of the lesion, the underlying disorder, and the wishes of the patient 2.
- Treatment options include primary repair, serial excision, skin grafting, local flaps, and tissue expansion 2.
- In some cases, no surgical intervention may be attempted if the patient has no cosmetic or functional complaint 2.
- Surgical treatment may be performed when there is an aesthetic demand, but clinical observation and close follow-up is also a good treatment choice for patients with stable disease or mild symptoms 3.
Surgical Challenges and Considerations
- CVG can present complications in performing craniotomy, most notably during the scalp exposure and closure 4.
- The thickening of the scalp can cause bleeding and difficulty in achieving hemostasis using Raney clips 4.
- A combined neurosurgical and plastic surgical approach may be necessary to manage the complexities of CVG 4.
- Direct excision of gyriform skin is a successful surgical approach to the rare skin deformity of CVG, resulting in a major reduction of the facial skin distortion and improved quality of life 5.