Cutis rhomboidalis nuchae
Alerts and Notices
Synopsis

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.
Codes
ICD10CM: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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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


Overview
Cutis rhomboidalis nuchae refers to the manifestation of long-term, prolonged sun exposure and resultant damage to the skin occurring on the back of the neck. Long-term, chronic sun exposure causes thickening of the most superficial layer of the skin (the epidermis) and abnormalities in the composition of the middle layer of the skin (the dermis).Who’s At Risk
Cutis rhomboidalis nuchae occurs in adults, particularly those with a history of prolonged sun exposure.Signs & Symptoms
Cutis rhomboidalis nuchae appears on the back of the neck as deep wrinkling and furrowing of the skin associated with a leathery texture.Self-Care Guidelines
For prevention of cutis rhomboidalis nuchae and other signs of sun damage, sun exposure should be avoided midday (10:00 AM to 3:00 PM), sun-protective clothing should be worn (tightly woven clothes and hats), and sunscreen should be applied (SPF 30 UVA and UVB block).When to Seek Medical Care
Cutis rhomboidalis nuchae does not require medical intervention but is a sign of severe sun damage.Treatments
No treatment is needed for cutis rhomboidalis nuchae.References
Bolognia, Jean L., ed. Dermatology, pp.1380-1381. New York: Mosby, 2003.