Case and Research Letter
Primary Nonessential Cutis Verticis Gyrata
Cutis verticis gyrata primaria no esencial
V. López
, E. Montesinos, E. Jordá
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Servicio de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, Spain
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Patchy foci of segmental fibrinoid necrosis with leukocytoclasia and mixed infiltrates in the dermal and hypodermal vessels (hematoxylin-eosin, original magnification x4).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Llamas-Velasco, D. de Argila, J. Fraga, A. García-Diez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Llamas-Velasco" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "de Argila" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Fraga" ] 3 => array:2 [ "nombre" => "A." 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"apellidos" => "Unamuno" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S000173101100072X" "doi" => "10.1016/j.ad.2010.09.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S000173101100072X?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219011000138?idApp=UINPBA000044" "url" => "/15782190/0000010200000006/v1_201304241225/S1578219011000138/v1_201304241225/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Primary Nonessential Cutis Verticis Gyrata" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "475" "paginaFinal" => "476" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "V. López, E. Montesinos, E. Jordá" "autores" => array:3 [ 0 => array:4 [ "nombre" => "V." "apellidos" => "López" "email" => array:1 [ 0 => "veronica_17@live.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Montesinos" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Jordá" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cutis verticis gyrata primaria no esencial" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 754 "Ancho" => 952 "Tamanyo" => 118211 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical image of furrows and folds on the patient's scalp.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 16-year-old boy with mental retardation was referred to our department because of folds in the scalp that had begun to develop 10 years earlier. The patient had no family history of similar lesions and denied any previous history of inflammation of the scalp or signs and symptoms of neurologic or psychiatric disorders.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Physical examination revealed folds and furrows running in an anteroposterior direction over the scalp that could not be corrected by traction (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). No areas of alopecia were observed nor were there differences in hair distribution between affected areas and areas of normal skin. The rest of the physical examination revealed no other significant skin lesions.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">A full laboratory workup, including a complete blood count, biochemistry, urinalysis, magnetic resonance imaging, skin biopsy, and chromosome analysis revealed no significant alterations, and there were no relevant findings on ophthalmologic study.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Based on the clinical features and the results of the tests performed, we made a diagnosis of primary nonessential cutis verticis gyrata. The patient and his family were informed of the benign nature of the lesion and no treatment was performed. Subsequent follow-up revealed no change in the condition.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Cutis verticis gyrata, first described in 1837 by Alibert, is a term that refers to a condition characterized by folds or deep furrows that resemble the surface of the brain.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The male to female ratio is 5-6 to 1. Presentation is before puberty in the majority of cases and only 10% develop after 30 years of age; secondary cutis verticis gyrata can appear at any age, depending on the underlying pathology. The etiology of this condition is varied and 2 groups have been described, with primary and secondary variants. Cutis verticis gyrata may thus be classified as primary (essential and nonessential) or secondary. The term primary essential is used in cases with no other associated abnormalities, and primary nonessential refers to cases associated with mental retardation, cerebral palsy, epilepsy, schizophrenia, neurologic abnormalities, deafness, ophthalmologic abnormalities, or a combination of any of these. Secondary cutis verticis gyrata has been associated with various other conditions, including inflammatory diseases, hamartomatous lesions, tumors, acromegaly, myxedema, idiopathic hypertrophic osteopathy, amyloidosis, syphilis, leukemia, cretinism, acanthosis nigricans, tuberous sclerosis, neurofibromatosis, Ehlers-Danlos syndrome, and trauma.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–5</span></a> Chromosome abnormalities have been observed in some cases.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Although the etiology and pathogenesis are unknown, autosomal recessive and dominant factors have been detected in sporadic cases of the primary essential form, and endocrine disturbances could be implicated in the primary nonessential form. The pathogenesis of the secondary forms will depend on the underlying disease.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In cutis verticis gyrata the skin gradually thickens, forming a variable number of folds and furrows that resemble the cerebral cortex. In most cases, the folds are parallel and run in an anteroposterior direction, though they may also be transverse in the occipital region.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–5</span></a> A distinctive feature of this condition is the impossibility of leveling the folds through traction or pressure. The areas affected may differ between individuals; lesions usually develop on the vertex of the scalp, though the temporal, frontal, and occipital regions can occasionally be involved. Accompanying symptoms will depend on the underlying cause of the cutis verticis gyrata, which is a benign disorder that usually requires no treatment. Surgery may be considered if the patient requests treatment for cosmetic reasons. The type of surgery will depend on severity, site of the lesion, and the underlying disease and can include simple excision, the placement of skin expanders, or skin grafts.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: López V, et al. Cutis verticis gyrata primaria no esencial. Actas Dermosifiliogr. 2011;102:475-476.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 754 "Ancho" => 952 "Tamanyo" => 118211 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical image of furrows and folds on the patient's scalp.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutis vertices gyrate and mental retardation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R. 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Kurozumi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Br J Plast Surg" "fecha" => "1997" "volumen" => "30" "paginaInicial" => "325" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010200000006/v1_201304241225/S1578219011000126/v1_201304241225/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010200000006/v1_201304241225/S1578219011000126/v1_201304241225/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219011000126?idApp=UINPBA000044" ]
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| 2021 Julio | 119 | 69 | 188 |
| 2021 Junio | 151 | 38 | 189 |
| 2021 Mayo | 141 | 81 | 222 |
| 2021 Abril | 118 | 84 | 202 |
| 2021 Marzo | 130 | 32 | 162 |
| 2021 Febrero | 102 | 35 | 137 |
| 2021 Enero | 63 | 25 | 88 |
| 2020 Diciembre | 65 | 20 | 85 |
| 2020 Noviembre | 39 | 24 | 63 |
| 2020 Octubre | 61 | 16 | 77 |
| 2020 Septiembre | 46 | 27 | 73 |
| 2020 Agosto | 40 | 33 | 73 |
| 2020 Julio | 36 | 36 | 72 |
| 2020 Junio | 40 | 53 | 93 |
| 2020 Mayo | 42 | 53 | 95 |
| 2020 Abril | 35 | 48 | 83 |
| 2020 Marzo | 39 | 24 | 63 |
| 2020 Febrero | 4 | 5 | 9 |
| 2020 Enero | 0 | 11 | 11 |
| 2019 Diciembre | 4 | 10 | 14 |
| 2019 Noviembre | 0 | 8 | 8 |
| 2019 Octubre | 0 | 7 | 7 |
| 2019 Septiembre | 4 | 19 | 23 |
| 2019 Agosto | 0 | 11 | 11 |
| 2019 Julio | 0 | 16 | 16 |
| 2019 Junio | 2 | 43 | 45 |
| 2019 Mayo | 0 | 104 | 104 |
| 2019 Abril | 0 | 68 | 68 |
| 2019 Marzo | 2 | 18 | 20 |
| 2019 Febrero | 0 | 15 | 15 |
| 2019 Enero | 2 | 15 | 17 |
| 2018 Diciembre | 1 | 8 | 9 |
| 2018 Noviembre | 1 | 9 | 10 |
| 2018 Octubre | 1 | 0 | 1 |
| 2018 Septiembre | 2 | 4 | 6 |
| 2018 Agosto | 0 | 14 | 14 |
| 2018 Julio | 0 | 1 | 1 |
| 2018 Junio | 0 | 3 | 3 |
| 2018 Mayo | 0 | 11 | 11 |
| 2018 Abril | 1 | 3 | 4 |
| 2018 Marzo | 6 | 0 | 6 |
| 2018 Febrero | 107 | 4 | 111 |
| 2018 Enero | 117 | 6 | 123 |
| 2017 Diciembre | 108 | 9 | 117 |
| 2017 Noviembre | 95 | 7 | 102 |
| 2017 Octubre | 82 | 9 | 91 |
| 2017 Septiembre | 101 | 25 | 126 |
| 2017 Agosto | 131 | 15 | 146 |
| 2017 Julio | 115 | 3 | 118 |
| 2017 Junio | 125 | 43 | 168 |
| 2017 Mayo | 94 | 15 | 109 |
| 2017 Abril | 157 | 10 | 167 |
| 2017 Marzo | 77 | 27 | 104 |
| 2017 Febrero | 420 | 6 | 426 |
| 2017 Enero | 75 | 11 | 86 |
| 2016 Diciembre | 75 | 13 | 88 |
| 2016 Noviembre | 104 | 16 | 120 |
| 2016 Octubre | 164 | 15 | 179 |
| 2016 Septiembre | 238 | 10 | 248 |
| 2016 Agosto | 181 | 7 | 188 |
| 2016 Julio | 91 | 4 | 95 |
| 2016 Junio | 6 | 5 | 11 |
| 2016 Mayo | 8 | 4 | 12 |
| 2016 Abril | 7 | 2 | 9 |
| 2016 Marzo | 12 | 9 | 21 |
| 2016 Febrero | 4 | 9 | 13 |
| 2016 Enero | 12 | 11 | 23 |
| 2015 Diciembre | 6 | 2 | 8 |
| 2015 Noviembre | 11 | 11 | 22 |
| 2015 Octubre | 9 | 14 | 23 |
| 2015 Septiembre | 8 | 4 | 12 |
| 2015 Agosto | 12 | 1 | 13 |
| 2015 Julio | 49 | 10 | 59 |
| 2015 Junio | 44 | 13 | 57 |
| 2015 Mayo | 72 | 22 | 94 |
| 2015 Abril | 80 | 14 | 94 |
| 2015 Marzo | 39 | 5 | 44 |
| 2015 Febrero | 43 | 9 | 52 |
| 2015 Enero | 47 | 10 | 57 |
| 2014 Diciembre | 54 | 8 | 62 |
| 2014 Noviembre | 62 | 16 | 78 |
| 2014 Octubre | 69 | 17 | 86 |
| 2014 Septiembre | 45 | 17 | 62 |
| 2014 Agosto | 60 | 17 | 77 |
| 2014 Julio | 49 | 25 | 74 |
| 2014 Junio | 66 | 16 | 82 |
| 2014 Mayo | 77 | 22 | 99 |
| 2014 Abril | 61 | 12 | 73 |
| 2014 Marzo | 55 | 19 | 74 |
| 2014 Febrero | 53 | 16 | 69 |
| 2014 Enero | 54 | 18 | 72 |
| 2013 Diciembre | 75 | 15 | 90 |
| 2013 Noviembre | 51 | 24 | 75 |
| 2013 Octubre | 50 | 24 | 74 |
| 2013 Septiembre | 48 | 28 | 76 |
| 2013 Agosto | 43 | 25 | 68 |
| 2013 Julio | 46 | 34 | 80 |
| 2013 Junio | 8 | 15 | 23 |
| 2013 Mayo | 13 | 12 | 25 |
| 2013 Abril | 11 | 10 | 21 |
| 2013 Marzo | 13 | 6 | 19 |
| 2013 Febrero | 35 | 9 | 44 |
| 2013 Enero | 62 | 6 | 68 |
| 2012 Diciembre | 33 | 4 | 37 |
| 2012 Noviembre | 5 | 2 | 7 |
| 2012 Octubre | 1 | 3 | 4 |
| 2012 Agosto | 0 | 1 | 1 |
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