Cutis rhomboidalis nuchae
Alerts and Notices
SynopsisCutis 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.
L57.2 – Cutis rhomboidalis nuchae
89019003 – Cutis rhomboidalis nuchae
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
- Pseudoxanthoma elasticum
Patient Information for Cutis rhomboidalis nuchae
OverviewCutis 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 RiskCutis rhomboidalis nuchae occurs in adults, particularly those with a history of prolonged sun exposure.
Signs & SymptomsCutis rhomboidalis nuchae appears on the back of the neck as deep wrinkling and furrowing of the skin associated with a leathery texture.
Self-Care GuidelinesFor 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 CareCutis rhomboidalis nuchae does not require medical intervention but is a sign of severe sun damage.
TreatmentsNo treatment is needed for cutis rhomboidalis nuchae.
Bolognia, Jean L., ed. Dermatology, pp.1380-1381. New York: Mosby, 2003.
Cutis rhomboidalis nuchae