Epidermal nevi

Yulia Farida Yahya Dep I kesehatan Kulit & Kelamin FK UNSRI-RSUP M Hoesin Palembang

 Epidermal nevus (EN) generalized term hamartomas proliferations epithelium Sub-type EN differ according the predominant histologic cell type keratinocyte (verrucous epidermal nevus), sebaceous gland (nevus sebaceous), pilosebaceous unit (nevus comedicus), eccrine gland (eccrine nevus) or apocrine gland (apocrine nevus)

Classification epidermal nevi

Epidemiology
Epidermal nevi occur in 1 in 1000 live births 80% lesion appear within the first year of life There are rare report of adults EN 60 year old women There are an equal male-female prevalence Most common sporadic Some familial cases have been documented

Clinical features
Verrucous epidermal nevicharacteristic by localized or diffuse, closely set skin-colored, brown or gray-brown verrucous papules, coalesce form welldemarcatedpapillomatous plaque Linear configurations common on the limbs as is distribution in Blaschkos lines or in relaxed skin tension lines

Verucous epidermal nevus

Verucous epidermal nevus

Verucous epidermal nevus showing linear configuration

Also known linear verrucous epidermal nevus or linear epidermal nevus

Nevus unius lateris

Extensive distribution of verrucous epidermal nevus is termed systemized epidermal nevus Epidermal nevus affecting one half body

Inflammatory linear verrucous epidermal nevus (ILVEN)

A variant EN inflammatory linear verrucous epidermal nevus (ILVEN)

most commonly on the buttocks & lower extremities & resemble linear psoriasis Inflammatory linear verrucous epidermal nevus showing psoriasiform erythema, scaling, & hyperkeratosis. The nodule ob the left leg giant wart

Epidermal nevus

showing hyperkeratosis,acantosis, papillomatosis & elongation rete ridge

Differential diagnosis linear EN

Treatment
Complete excision EN to the level of the deep epidermis necessary to prevent recurrence Multiple surgical & medical treatmentto destroy lesions laser ablation, electrofulguration, cryotherapy, medium-full depth chemical peels to full or partial destruction of lesions

Treatment
Topical retinoic acid or calcipotrioladjunctive therapy to increase efficacy surgical intervention Systemic retinoids & anti-psoriatic agent clinical improvment Etanercept successfull treatment ILVEN

Nevus sebaceous

Clinical feature
Lesion flat at birth plaquelike under the hormonal influances of puberty

Nevus Sebaceous
Nevus sebaceous also known as Nevus sebaceous of Jadasson & organoid nevus
Linier,hairless,yellow,waxy & verrucous plaque Localisation scalp. face

histopathologic

hyperplasia & Nevus sebaceous epidermal increased sebaceous gland & apocrine glands in dermis

Differential diagnosis
Aplasia cutis Congenital triangular alopecia clinical app similar to nevus sebaceous Biopsy

Treatment
Excision NC when lesion increased risk BCC Demand pathologic Rapidly growing papules or nodule evaluate for rare malignancies

Nevus comedonicus

Nevus comedonicus

Nevus comedonicus

Nevus comedonicus
Also known comedo nevus,nevus follicularis keratinosis, nevus acneiformis unilateralis, nevus zoniforme Nevus comedonicuslinier closely set comedones

Differential diagnosis
Acne vulgaris Milia Acne neonatorum Nevus sebaceous Milia Acne neonatorum

Treatment
Nevus comedonicus usually asymptomatic Treatment based on the cosmetic concern Inflammatory variant significant suppuration & pain, requering medical or surgical intervention Surgical therapy extraction, excision, dermabrasion or Lasaer resurfacing good clinical results