Man of stone: A case of a chronic actinic dermatitis mimicking a cutis verticis gyrata

Bourgaux, M.; Marcaillou, M.; Matei, I.; Delaumenie, S.; Prudhomme, R. O.; Souyri, N.; Bédane, C.

doi:10.1111/jdv.16068

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…Primary non-essential CVG is usually associated with neurological and ophthalmological disorder, such as intellectual disability, epilepsy, deafness, cataracts, strabismus and blindness [ 14 ]. The clinical presentation of secondary CVG varies depending on the underlying cause, including hormone-related diseases such as acromegaly, pituitary tumors, thyroid diseases, or myxedema; cutaneous inflammatory such as tuberous sclerosis, eczema, psoriasis, acne conglobate, or Darier disease; infectious diseases such as syphilis or human immunodeficiency virus; neoplasms diseases such as leukemia, or T-cell lymphoma [ 4 , 5 , 7 , 10 , 15 , 16 ]. The histopathology of the primary CVG will reveal hypertrophy and hyperplasia of epidermal appendages and thickened dermal collagen in skin, whereas the histopathological changes in secondary CVG shows abnormalities characteristic of the underlying etiology [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

A rare cutis verticis gyrata secondary to cerebriform intradermal nevus: case report and literature review

Zeng

Guo

2021

BMC Surg

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Background Cutis verticis gyrate (CVG) is a rare morphologic syndrome that presents with hypertrophy and folding of the scalp. CVG can be classified into three forms: primary essential, primary non-essential, and secondary. Cerebriform intradermal nevus (CIN) is a rare cause of secondary CVG. We are here to report a rare case of CVG with an underlying CIN and discuss the clinical course, treatment options, and critical screening guidelines for these patients. Case presentation A 25 year-old male patient presented with a chief complaint of generalized hair loss in the scalp parietaloccipital region for a duration of 1 year and the hair loss area was occasionally accompanied by mild itching. The hair loss started gradually and worsened over time. In addition, he had scalp skin folds resembling the ridge and furrow of the cerebral cortex in the parietaloccipital region since birth. Physical examination revealed hypertrophy and formation of folds in the parietal-occipital area, forming 5 to 6 furrows and ridges. The size of the cerebriform mass was about 12.0 cm × 8.5 cm, without other skin lesions. Diffuse non-scarring hair loss was distributed on the posterior-parietal scalp, mid-parietal scalp and superior-occipital scalp. The diseased tissue of the patient's parietaloccipital area was excised under general anesthesia. The postoperative pathological examination of the tissue excised showed that there were dense intradermal melanocytic nevus, so the patient was diagnosed with secondary CVG caused by CIN. At the 2 year follow-up, there were no obvious changes in the lesions. Conclusions CIN must be differentiated from other conditions that manifest as CVG, including primary essential or non-essential CVG and secondary CVG caused by other reasons. Each CIN patient requires a specific decision of whether to excise the lesion surgically or follow a wait-and-see policy, depending on the patient's will and specific condition. Surgical treatment may be performed when there is an aesthetic demand. However, clinical observation and close follow-up is also a good treatment choice for patients with stable disease or mild symptoms.

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Section: Discussionmentioning

confidence: 99%

A rare cutis verticis gyrata secondary to cerebriform intradermal nevus: case report and literature review

Zeng

Guo

2021

BMC Surg

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“… 3 Some hypotheses suggest that the disease mechanism may involve a delayed-type hypersensitivity reaction to an endogenous photoinduced antigen, postulated as UV-altered DNA. 9 , 10 It is believed that the recognition of UV-induced neoantigens by lymphocytes in the skin may underlie this process. 7 While CAD affects individuals of any sex and age, it primarily develops in men over 50 years of age, 11 , 12 particularly those with fair skin, 13 often engaging in outdoor activities.…”

Section: Introductionmentioning

confidence: 99%

Successful Treatment of Chronic Actinic Dermatitis with Tofacitinib

Zhong,

Ali,

Yang

et al. 2024

CCID

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We present the case of a 58-year-old male patient who presented with pruritic skin plaques and papules on the scalp, face, back, and back of the hands for over a year. The symptoms worsened upon exposure to sunlight and improved on cloudy days. Despite previous attempts at treatment with glucocorticoid ointment and antihistamine drugs, the patient experienced progressive aggravation of symptoms. Physical examination revealed hypertrophic and infiltrating nodules, with significant scratches and local exudation. Skin biopsy confirmed the diagnosis of sun-induced dermatosis. The patient was initiated on tofacitinib, an oral Janus Kinase inhibitor, along with a halometasone ointment, oral ebastine tablets, and strict sun protection. Over the course of four revisits spanning four months, the patient experienced a significant improvement in symptoms, with the rash almost disappearing and pruritus subsiding. The treatment was well tolerated and no adverse effects were observed. Follow-up for six months post-treatment showed no recurrence of symptoms. This case highlights the efficacy of tofacitinib in managing sun-induced pruritic plaques and suggests it as a potential therapeutic option in similar cases.

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Cutaneous Photosensitivity Diseases

Ibbotson

2024

Rook's Textbook of Dermatology

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The photodermatoses are a diverse group of conditions in which abnormal responses to light exposure are the hallmark. Photodiagnostic investigations through a specialist unit may be essential to ensure accurate diagnosis and management, and this chapter explores the nature of the photodermatoses and the photodiagnostic techniques that can be applied. Management approaches include early diagnosis, prevention and disease suppression, and awareness of the significant adverse impact on well‐being and psychological health that can occur with photosensitivity. Photoprotection is a mainstay approach for the photodermatoses but is often not sufficient alone for disease control. Desensitisation through natural hardening or light‐based therapies may be feasible, although systemic immunosuppressants and immunomodulators may be required. Awareness of the possibility of vitamin D deficiency is also necessary. This chapter will cover these approaches in detail.

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Man of stone: A case of a chronic actinic dermatitis mimicking a cutis verticis gyrata

Cited by 3 publications

References 6 publications

A rare cutis verticis gyrata secondary to cerebriform intradermal nevus: case report and literature review

A rare cutis verticis gyrata secondary to cerebriform intradermal nevus: case report and literature review

Successful Treatment of Chronic Actinic Dermatitis with Tofacitinib

Cutaneous Photosensitivity Diseases

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