Pachyderma Folded

Folded pachyderma (cutis verticis gyrata; synonym - folded scalp) is a rare dermatological disease characterized by the formation of multiple skin folds on the scalp.

The causes of folded pachyderma are not completely clear. It is assumed that the underlying cause is a congenital abnormality of connective tissue, leading to excessive skin growth in certain areas. The disease is more often observed in men and appears between the ages of 30 and 60 years.

Clinically, pachyderma is characterized by the presence of multiple folds of skin, located mainly in the forehead and parietal area. Folds can be of various shapes and sizes - from small to large, symmetrical and asymmetrical. The skin in the fold area appears thickened and hyperpigmented.

To make a diagnosis, visual inspection and palpation of the affected areas are performed. Additional examination methods are not required.

Treatment for folded pachyderma involves surgical excision of excessively folded areas of skin. After surgery, relapses are rare. The prognosis is favorable.

PACHYDERMIA FOLCATUS is a common skin condition characterized by multiple superficial jagged wrinkles on the scalp. There are 3 forms of folded pachyderma - two-form (dimorphic), three-form and four-form. _Biform (dimorphic, most common) pachydermia._ The tortuosity of the hair shaft and the random arrangement of trabeculae are noted. In this case, the skin appears to have a rough surface, as if “perforated.” When pressing with a finger across the width of the scalp from the occipital line to the border of hair growth, a dimple appears, which disappears after 5-10 s. Biform pachydersia occurs in childhood, usually without changes in the structure of the hair shafts. In adult patients with the three- or four-form form, women predominate.

_Three or four-form pachydermia._ Both types of the process occur. Three- or four-shaped pahyderzia is characterized by the formation of notches on the skin, located transversely, but close to the vertical plane passing through the hairline. Sometimes (especially in the dynamics of the disease in adults) a network of lines is visible on the surface. It is diagnosed by repeated tapping of the skin on the scalp with pressure - the loss of the height of the indentation is determined. With a relatively small increase in the periosteum, it can sometimes be visible through the skin. Involution of pathological changes does not always occur.

**Treatment** Must be carried out to increase the effectiveness of correction and achieve the best result. Typically, primary treatment consists of a combination of topical and oral medications, as well as procedures that include: * Reviewing a sample exercise schedule, * Developing a healthy diet, * Following individual instructions on physical activity and other methods.