A unique overlap of scarring and non-scarring alopecia in primary cutis verticis gyrata

Abstract

Cutis verticis gyrata (CVG) is a rare scalp disorder characterized by cerebriform thickening and folding of the scalp skin. It can present as a primary essential form without underlying systemic involvement. Alopecia, classified as scarring or nonscarring, may rarely accompany CVG. We report a 55-year-old female with primary essential CVG exhibiting both nonscarring alopecia areata and scarring lichen planopilaris, which were confirmed histopathologically. No neurological, ophthalmological, or systemic abnormalities were present. Magnetic resonance imaging revealed no intracranial or cranial bone pathology. To our knowledge, this is the first reported case of simultaneous scarring and non-scarring alopecia in a patient with primary essential CVG. This rare coexistence may reflect the presence of multiple autoimmune pathways targeting different segments of the hair follicle. Clinicians should consider combined pathological mechanisms in unusual alopecia presentations associated with CVG.