Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Nov 24;56(6):544-547.
doi: 10.1055/s-0043-1776897. eCollection 2023 Dec.

Bulldog Scalp Syndrome

Mohd Altaf Mir  1 , Jaya Jain  1 , Prince Kumar  1 , Rajesh Maurya  1 , Manjit Kaur Rana  2 , Aakansha Giri Goswami  1
Affiliations
Case Reports

Bulldog Scalp Syndrome

Mohd Altaf Mir et al. Indian J Plast Surg. .

Abstract

Bulldog scalp syndrome or cutis verticis gyrata (CVG) is a rare cutaneous disorder with an incidence of just 0.026 to 1 per 100,000 population and cosmetic problems should not be ignored as they can affect the quality of life of patients in social and psychological aspects. In CVG the scalp thickens to form folds resembling sulci and gyri just as the skin fold of bulldog. It is a clinical diagnosis with various etiologies. It is classified as primary essential or nonessential and secondary CVG. It can manifest with symptoms ranging from mild to severe intensity. Cosmetic problems are the major concern that can affect patients' social and psychological health. If the folds are heavy, they can cause mass symptoms. Thus, surgery remains the definitive treatment option for improving the cosmetic appearance. Both our cases have different etiologies, however, were managed surgically with removal of skin folds (gyrae) and scoring of aponeuroses of the scalp followed by stretching of the scalp and closure to improve appearance. The surgical team as well as patients were satisfied with the appearance of the scalp after healing. CVG though a rare disease with various etiologies is a benign condition with good prognosis with no reports of malignant transformation so far.

Keywords: bulldog scalp; cutis verticis gyrata; scalp flap.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Posterior view of the scalp showing convoluted skin fold occupying the whole occiput hanging down the neck.
Fig. 2
Fig. 2
Low power microscopic image of histopathology analysis of the lesion: Individual cells exhibit minimal atypia. Dermis shows sheets and nests of nevus cells reaching up to the subcutis, adding evidence to our intraoperative finding, suggestive of melanocytic nevi.
Fig. 3
Fig. 3
Postoperative day 14 image showing good cosmetic results.
Fig. 4
Fig. 4
Posterior view of the scalp showing 2 to 3 regular gyri and sulci.
Fig. 5
Fig. 5
Microscopic images of histopathological specimen showing convoluted epidermis and dermis suggestive of cutis verticis gyrata. However, other histological features are normal.
Fig. 6
Fig. 6
Postoperative day 10 image of patient showing good cosmetic results with hair growth.
See this image and copyright information in PMC

References

    1. Shareef S, Horowitz D, Kaliyadan F.Cutis Verticis Gyrata 2023. Jul 10. In: StatPearls [Internet].Treasure Island (FL)StatPearls Publishing; 2023 Jan - PubMed
    1. Yang J J, Sano D T, Martins S R, Tebcherani A J, Sanchez A P. Primary essential cutis verticis gyrata - case report. An Bras Dermatol. 2014;89(02):326–328. - PMC - PubMed
    1. Larsen F, Birchall N. Cutis verticis gyrata: three cases with different aetiologies that demonstrate the classification system. Australas J Dermatol. 2007;48(02):91–94. - PubMed
    1. Lamelas A M, Taub P J, Silver L, Kressel A. Congenital primary essential cutis verticis gyrata. Eplasty. 2016;16:ic13. - PMC - PubMed
    1. Schöttler L, Denisjuk N, Körber A, Grabbe S, Dissemond J. Asymptomatic cerebriform folds of the scalp. Diagnosis: primary cutis verticis gyrata (CVG) [in German] Hautarzt. 2007;58(12):1058–1061. - PubMed

Publication types