ODP341 Pachydermia lesions identified on imaging in a cohort of acromegaly patients

INTRODUCTION: Pachydermia is a clinical term derived from the former taxonomic order of mammals pachydermata, and it corresponds to a benign thickening and furrowing of the skin. It is classically associated with pachydermoperiostosis, but it can emerge in another conditions, including in acromegaly. These lesions may be distributed throughout the body. When they are mainly located to the scalp and forehead, resembling cerebral gyri, they receive the designation of cutis verticis gyrata (CVG). These are seldomly reported in acromegaly patients. Therefore, with this study we aimed to assess the prevalence of these pachydermia lesions in the patients with acromegaly followed at our center. MATERIALS AND METHODS: We retrospectively reviewed the head magnetic resonance imaging (MRI) of 42 patients with acromegaly followed at our center. We inspected the composition, thickness and shape of the scalp, and those cases with more than 1 unequivocal furrow on the skin/connective tissue of the scalp region visible on the MRI were considered as a patient displaying pachydermia lesions. Demographic data and IGF-I levels at diagnosis were also registered. RESULTS: Six out of the 42 (14%) acromegaly patients displayed pachydermia lesions identifiable on MRI. Of the 6 patients, 4 had pachydermia lesions in the parietal area, while the occipital and the temporo-occipital regions were each involved in 1 patient. The mean age of these six patients were 51±10yr, and there were 4 males and 2 females. Their serum IGF-1 levels at the diagnosis of acromegaly were 1125±326ng/mL (minimum and maximum IGF-1 levels were respectively 517 and 1358), and 5 of the six patients were identified with a pituitary macroadenoma at diagnosis, while only one patient had a microadenoma. DISCUSSION: Pachydermia lesions are uncommonly reported in patients with acromegaly, although their prevalence might be significant in this setting, particularly in male patients, as demonstrated in this study. Pachydermia lesions may be depicted on imaging studies, thus clinical examination together with careful inspection of the scalp and skin on radiological studies may be important to identify such lesions, which in turn may contribute for an earlier diagnosis of acromegaly or facilitate the investigation of other etiologies. Presentation: No date and time listed