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Congenital verrucous epidermal nevus

Gerardo Rivera-Silva1, Aarón Morín-Juárez1, Sebastián Márquez-Murillo1, Héctor R. Martínez-Menchaca2

Author Affiliation

1Medical Scientist, Department of Basic Sciences, School of Medicine, University of Monterrey, Monterrey, NL, Mexico, 
2Pediatric Dentist, Department of Comprehensive Dentistry, School of Dentistry, University of Louisville, Louisville, KY, USA

Abstract

A 9-year-old male presented with an asymptomatic, confluent, and hyperpigmented skin lesion on the right lateral trunk region presented at birth. No changes in color and consistency are reported, excepting that the lesion enlarged in proportion to the patient´s growth. The mother informed that the patient was diagnosed with anxiety one year ago. Physical examination revealed a large, hyperpigmented, and confluent patch of overgrown skin with a dimension between 20 cm long and 15cm wide associated with painless verrucous plaques located on the right lateral trunk region

DOI: 10.32677/yjm.v2i3.3854

Pages: 179-179

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Download: 3

DOI URL: https://doi.org/10.32677/yjm.v2i3.3854

Publish Date: 19-12-2023

Full Text

A 9-year-old male presented with an asymptomatic, confluent, and hyperpigmented skin lesion on the right lateral trunk region presented at birth. No changes in color and consistency are reported, excepting that the lesion enlarged in proportion to the patient´s growth. The mother informed that the patient was diagnosed with anxiety one year ago. Physical examination revealed a large, hyperpigmented, and confluent patch of overgrown skin with a dimension between 20 cm long and 15cm wide associated with painless verrucous plaques located on the right lateral trunk region (Fig. 1A).

Figure 1: General appearance of the nevus (a). Cervical radiological images of anteroposterior (b) and lateral (c) views, showing left convexity scoliosis

The laboratory investigations revealed a H1047R mutation in the PIK3CA gene. The anatomopathological study showed hyperkeratosis, acanthosis, and papillomatosis compatible with verrucous epidermal nevi (hamartomas). Anteroposterior (Fig. 1B) and lateral (Fig. 1C) neck radiographs revealed a left convexity scoliosis.  Based on the clinical, pathologic, and radiologic findings, the patient was diagnosed with verrucous epidermal nevus (VEN). This clinical condition could be associated with abnormalities in neurologic, ophthalmologic, or skeletal systems.

VEN is a benign epidermal nevus which appears at birth or during the first five years of live [1]. When this type of nevi is located on the trunk, it is associated with alterations in the bone curvatures of the spine, and/or in the bones of the arms or legs and is associated with mutations in the PIK3CA gene [2]. The patient had therapy with shave excision followed by a phenol peeling medical; however, it is not possible to predict when skin lesions will recur [3].

Learning Points

  • Verrucous epidermal nevus is a rare, benign patch-like skin disorder usually present at birth.
  • The diagnosis is established on clinical presentation.
  • This nevus is habitually resistant to various treatment modalities.

CONSENT FOR PUBLICATION

Written informed consent was obtained from parents for the publication of this case report and all associated images.

AUTHORS’ CONTRIBUTIONS

All authors contributed to the completion of this work. The final manuscript was read and approved by all authors

References

  1. Saini S, Agarwal S, Yadav C, et al. Verrucous Epidermal Nevus with Unusual Presentations: A Case Series of 5 Cases. Indian J Dermatol. 2022;67(3):317.

  2. Miranda LQ, Fracaroli TS, Fonseca JC et al. Analysis of mutations in the PIK3CA and FGFR3 genes in verrucous epidermal nevus. An Bras Dermatol. 2013;88(6 Suppl 1):36-8.

  3. Arora B, Singh Khinda VI, Bajaj N, et al. Congenital epidermal nevus. Int J Clin Pediatr Dent. 2014;7(1):43-6.