Cutis verticis gyrata

Abstract

A 61-year-old man was seen in the Ulcer Clinic at Bellevue Hospital Center and was referred to Dermatology Clinic for evaluation of a leonine facies. The patient noted progressive wrinkling and thickening of the skin of his forehead over the last thirty-eight years. The change was gradual, and he brought photographs that showed the deepening of the furrows over time. The patient denied any other skin lesions, dysasthesias, or active infections. Past medical history included pre-diabetes, hyperlipidemia, and chronic venous insufficiency. PHYSICAL EXAMINATION:On the central forehead and glabella were exaggerated skin folds that were interrupted by deep-undulating furrows (Figure 1). The scalp was normal. The facial folds gave the appearance of a leonine facies.