Epidermal Nevi
Section snippets
Epidermal nevi
Epidermal nevi are noted at birth or within the first year as a linear tan patch or thin plaque. The linear pattern often follows Blaschko lines, which are believed to represent patterns of epidermal migration during embryogenesis (Figs. 1 and 2). Rarely, epidermal nevi do not develop until later in childhood. Initially, they may present as flat tan soft or velvety plaques. The natural history of epidermal nevi is that, around the time of puberty, they tend to become thicker, verrucous, and
Nevus sebaceous
Nevus sebaceous, also referred to as nevus sebaceus of Jadassohn, is a common hamartoma of the epidermis, hair follicles and sebaceous and apocrine glands. Nevus sebaceous usually presents at birth as a yellow-orange to pink, finely papillomatous, alopecic plaque that is often oval or linear (Fig. 3). The size may vary from less than a centimeter to several centimeters in length, and a patient can rarely have multiple lesions. There are a few reports of unusually large and exophytic lesions for
Nevus comedonicus
Nevus comedonicus is a developmental anomaly of the pilosebaceous unit that typically presents at birth or during childhood. Clinically, a nevus comedonicus presents as a linear array or cluster of dilated follicular orifices plugged with keratin, resembling comedones. Larger lesions typically follow Blaschko lines and extensive involvement of half the body has been described.48, 49 Nevus comedonicus seems to have a predilection for the face, neck, or trunk, but can involve the extremities,
Becker nevus
Becker nevus, also referred to as Becker melanosis or pigmented hairy epidermal nevus, is a common type of epidermal nevus that occurs most frequently on the trunk or proximal upper extremities of young men (Fig. 4). Studies of young male military recruits in France and Italy found a prevalence ranging from 0.25% to 2.1%.66, 67, 68 Many more cases have been reported in males than females, but the true male/female ratio is unknown.69, 70 Becker nevus typically presents as a hyperpigmented patch
Inflammatory linear verrucous epidermal nevus
Inflammatory linear verrucous epidermal nevus (ILVEN) is a type of epidermal nevus characterized by pruritic erythematous scaly papules and plaques. They may be present at birth or develop during early childhood. The differential diagnosis includes linear psoriasis, lichen striatus, linear lichen planus, and epidermal nevus with verrucous changes. The prognosis is variable, often waxing and waning with time. Treatment options that have been described as leading to temporary improvement include
Porokeratotic eccrine ostial and dermal duct nevus
Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) is a rare malformation often classified as an eccrine hamartoma. Clinically, it presents as hyperkeratotic papules and plaques with comedo-like punctuate pits, often filled with keratin plugs. Lesions are usually in a linear pattern, most commonly located on the palms or soles. There are several cases with widespread unilateral or bilateral lesions distributed along Blaschko lines.96, 97, 98 Although most of these lesions are present
Epidermal Nevus Syndrome
Several syndromes may be associated with epidermal nevi. The term epidermal nevus syndrome has been used to describe the association of an epidermal nevus with systemic features potentially affecting multiple organs including neurologic, ocular, skeletal, and in rare cases, cardiac and renal anomalies.3 Even small epidermal nevi, especially in the setting of other cutaneous findings may be associated with syndromes or warrant further consideration for neurocutaneous, genetic, or metabolic
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