Rare Congenital Frontal Hairline Deformity with Temporo-Parieto-Occipital Multiple Folds of Scalp

Abstract

Two cases of congenital hairline deformity are reported. Both cases exhibited multiple wrinkled areas in the lower occipital region, with hair that punctured and irritated the adjacent skin as it grew, creating ulcerated lesions. Both patients had a unilateral folded and raised wrinkled and twisted region stretching from the temporal area to the parietal and occipital areas. There was also a defect in the frontotemporal hairline of the affected side that was not present on the contralateral side. The skin of the forehead was also thinner on the affected side. Both patients were in good physical health and had no other congenital abnormalities or pertinent family history. There were no other skin, neurological, or physical abnormalities. In each case, the excessive skin was excised from the temporo-occipital region and microscopically dissected into follicular units, which were transplanted into the temporal area and the frontal hairline. Histologic examination did not reveal any specific abnormal findings. The transplanted hairs were well engrafted and showed natural results. Congenital anomalies of the hairline or hair-bearing scalp tissue are rare. Cutis verticis gyrata is a rare disease that causes multiple furrows and folds of the scalp. However, the cases reported here exhibited a somewhat different appearance from that of cutis verticis gyrata, as multiple folds were present in the scalp in each case, along with an alopecic lesion. This author has successfully treated 2 cases of this rare form of congenital hair loss that has not yet been reported to our knowledge.