Cutis rhomboidalis nuchae L57.2

Leathery aspect with thickening of the yellowish tinged neck skin, as well as formation of deep, diamond-shaped furrows as a sign of a pronounced senile elastosis; partial symptom of the Landmannshaut. The cutis rhomboidalis nuchae represents an independent risk factor for the occurrence of basal cell carcinoma (Odd`s ratio of 1.8).

A grading of the severity in 4 levels is accepted:

• grade 0: no signs of cutis rhomboidalis
• Grade 1: Indicated furrow formation, no skin discoloration, no skin thickening
• Grade 2: Moderate furrow formation, moderate skin thickening
• Grade 3: deep furrow formation, pronounced skin thickening, yellowish discoloration

Almost exclusively men are affected

Degenerative elastotic changes due to excessive cumulative UV exposure

Age > 60 years

Neck, more rarely lateral neck parts

Chronically UV-exposed skin is yellowish in colour, leathery and firm, and characterised by a rough, diamond-shaped relief that runs down to the sides of the neck. This rhomboidal relief is often interspersed with black retention comedones (a similar process is observed in the area of the lateral cheek bones in elastoidosis cutanea nodularis et cystica ).

Consistent light protection with sunscreens, avoidance of direct sunlight and textile sun protection are indicated to prevent the progression of the disease. Blande skin care e.g. with Ungt. emulsif. aq., s.a. Elastosis actinica.

1. Wolllina U (2015) Cutis rhomboidalis nuchae and occupational UV-related skin cancer. Dermatology at work and in the environment 63: 137-140