Secondary Cutis Verticis Gyrata Induced by Long-Term Use of High-Dose Topical Minoxidil

Cutis verticis gyrata (CVG) is a medical condition that is characterized by thickening of the scalp giving the scalp a cerebriform appearance. Due to an apparent paucity of the condition, limited research exists, and causes are as yet undetermined. What is known, is that the condition may either be a feature of several syndromes or occur as a consequence of a number of diseases or drugs that produce changes in scalp structure, particularly acromegaly, and theoretically, the use of growth hormone (GH) itself or the use of drugs that mimic the effect of GH (secretagogues).

We present a case of CVG that resulted from long-term topical use of minoxidil at a high concentration.

Minoxidil has been shown to be able to potentiate the mitogenic effects of insulin-like growth factor (IGF-1). Meanwhile, the striking manifestations of acromegaly are due to excessive IGF-1 production by the liver in response to GH stimulation. The growth-promoting properties of IGF-1 trigger soft tissue hypertrophy, and hypertrichosis. Pseudoacromegaly has been reported to be induced by the long-term use of oral minoxidil. This is the first case report of secondary CVG from the use of topical minoxidil for the treatment of male androgenetic alopecia.