Chronic Exposure to (abstract) sunlight causes various skin manifestations and if it is a prolonged exposure as in farmers and those who take sunbath, it will end up in thickened diamond shaped skin called as cutis rhomboidalis nuche, neck being common site hence the name.


A 60 Years old male farmer came with non-itchy thickened skin over the neck and he has been suffering from the condition for the past 10 years. He gave a history of exposure to sun rays for a period of around 40 years, more than five to six hours daily.

On examination, he had hyper pigmented diamond shaped thickened skin over the neck. He came not for the cosmetic problem but he feared about the condition and worried about a malignancy. He had applied a lot of native medicine including turmeric.

Since no effective treatment is available, the patient was given the following advice:

  1. Patient consoled and given counseling.
  2. Strict advice given to avoid sun exposure.
  3. Regarding the use of fluent use of sunscreen cream once in 4 hours.
  4. He was advised to use polypodium leucomotos regularly and advised to come for review after two months.
  5. Topical retinoic cream in the night with and moisturizer.

Patient came for review 3 months later and evaluated for improvement. Moderate improvement was noted after 3 months. Photos were taken before and after treatment with the consent of the patient.

cutis rhomboidalis cutis rhomboidalis