Cutis verticis gyrata.

1 of 2 DESCRIPTION A 30-year-old male presented with headache and acral enlargement ( fi gure 1 ).On examination, he had bitemporal hemianopia, acanthosis nigricans, skin tags and cutis verticis gyrata (CVG) from which he was asymptomatic ( fi gure 2 ). On investigation, serum growth hormone (GH) after 75 g glucose load was 26.8 ng/ml (N, <1 ng/ml) with insulinlike growth factor 1 (IGF-1) of 1126 ng/ml (N, 117–329 ng/ ml). MRI head revealed a pituitary macroadenoma (20 × 15 × 15 mm). The unusual feature in the index case was the presence of CVG. CVG is a condition associated with excessive soft tissue proliferation with undulations of the scalp mimicking cerebral sulci and gyri. 1 The estimated prevalence of CVG is 1 in 100 000 in males 0.026 in 100 000 in females. 2 CVG can be classifi ed in two categories: (1) primary (non-essential and essential) and (2) secondary. The primary non-essential form may be associated with mental retardation,cerebral palsy, epilepsy, cataract and blindness while primary essential form is not associated with such abnormalities. 2