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06-26-2024, 09:04 PM
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Cutis Vertices Gyrata
Have you ever heard of a condition called CVG (cutis vertices gyrata)? A 30-year-old man was presented to a centre for burn and reconstructive surgery with an abnormal appearance of the scalp since puberty. Clinical examination revealed convoluted folds and furrows affecting the whole vertex and the upper part of the occipital region sparing both temporal regions. All routine laboratory tests were within normal range, indicating primary essential CVG. The nature of the disease was discussed with the patient. He was offered surgical treatment by expanding the affected part. Surgery was performed under general anaesthesia. The scalp was approached through a left temporoparietal curved incision; a 500-cc rectangular tissue expander was inserted in the subgaleal plane of the vertex region. The patient had an uneventful post-operative period. He was followed up twice weekly in the outpatient department for expander inflation, for a period of 2 months. After 2 months of inflation we observed that the scalp had flattened at areas of maximum tension over the expander which was then extracted followed by excision of the excess deformed scalp. The patient had an acceptable outcome without minor or major postoperative complications except for a small dog ear which was excised at a later stage. The patient was reviewed 18 months post-operatively. There was marked improvement with no recurrence of the disease. Histopathological examination of the excised tissue showed increased collagen content of the dermis surrounding the sweat glands that went deeply between the subcutaneous fat lobules, but there was disparity between the galeal and skin layers. |