Cutis rhomboidalis nuchae (CRN) is a common clinical variant of solar elastosis in which the skin of the posterior neck becomes thickened, leathery, and deeply furrowed in a geometric pattern. The condition is a marker of chronic sun damage with the subsequent development of disorganized and damaged collagen and elastic tissue.
CRN primarily affects elderly men and women with lighter skin phototypes and history of significant sun exposure. Outdoor occupations also predispose patients to CRN.
CRN is a chronic condition, and once the skin changes have occurred, it is difficult, if not impossible, to reverse the appearance of the skin.
Cutis rhomboidalis nuchae
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Synopsis
Codes
ICD10CM:
L57.2 – Cutis rhomboidalis nuchae
SNOMEDCT:
89019003 – Cutis rhomboidalis nuchae
L57.2 – Cutis rhomboidalis nuchae
SNOMEDCT:
89019003 – Cutis rhomboidalis nuchae
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Lichen simplex chronicus – Lines not as furrowed, and history of intense pruritus and rubbing is elicited.
- Systemic amyloidosis – More intense erythema, possible enlargement of the tongue, and biopsy demonstrates amyloid deposition.
- Favre-Racouchot syndrome – Acneiform lesions and agminated comedones.
- Psoriasis – Pink to red, erythematous, well-demarcated plaques with a silvery and micaceous scale; tends to involve the occipital scalp, which is relatively protected from the sun and not involved in CRN.
- Chronic actinic dermatitis
- Fibroelastopapulosis
- Pseudoxanthoma elasticum
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Management Pearls
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Therapy
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References
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Last Reviewed:10/20/2020
Last Updated:10/20/2020
Last Updated:10/20/2020
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Cutis rhomboidalis nuchae