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Objective: Recurrence and scar formation are the key leftover problems in the treatment of verrucous epidermal nevus (VEN). The objective of this study was to assess the long-term efficacy of bleomycin with triamcinolone acetonide in reducing the recurrence of VEN and scar formation after treatment. Methods: Bleomycin and triamcinolone were injected percutaneously into the lesion, and the drug was evenly distributed in the lesion. Several treatment courses were carried out according to the size and hyperplasia of the lesion. Necessary laser treatment was performed. Patients were followed up for 2–5 years. Results: The results showed that 83% of the patients were cured. The recurrence rate was 17%. The recurrence was localized and accounted for 3%–6% of the original lesion area. Scar formation accounted for 3.4%. Other complications did not occur. The patients or his/her guardian were satisfied with the treatment effect. Conclusion: Bleomycin with triamcin acetonide can significantly improve the cure rate of VEN and reduce the recurrence rate and scar formation. This method is a good option for VEN treatment.

An epidermal nevus (EN) is a common disease of various types, including verrucous EN, nevus sebaceous, inflammatory linear verrucous EN, Becker nevus, smooth muscle hamartoma, and nevus comedonicus. EN syndrome is a serious and difficult-to-treat syndrome that is complicated by two or more abnormal organs or systems. To date, the mechanism of an EN is still unclear, and the therapies remain unsatisfactory. The most frequently used treatments are surgery and laser therapy. Several drugs have also been tested. An EN requires more attention, and further research is needed to provide appropriate and effective treatments for each patient.

Proteus syndrome is a rare genetic disorder characterized by disproportionate and asymmetric overgrowth of bones and soft tissues. It is caused by a mutation in the AKT1 gene and manifests with various dermatological criteria such as connective tissue nevi and vascular malformations. This article presents a case study of a 3-year-old girl with Proteus syndrome, highlighting the important role of dermatologists in diagnosis and care coordination. Early childhood diagnosis is crucial for active surveillance and improving the patient's quality of life. A multidisciplinary approach involving various medical specialties is recommended to minimize complications. [Extracted from the article]

Verrucous epidermal nevi (VEN) are cutaneous hamartomas characterized by keratinocytic hyperplasia. Majority are linear in distribution and tend to follow the Blaschko lines; however, some may have zosteriform (segmental) or systematized distribution involving widespread areas of skin. The systematized ones are further classified into “Nevus Unius Lateris” when one-half of the body is affected, and “Ichthyosis Hystrix” showing bilateral distribution, both being the uncommon forms. Although it can affect any body part, it rarely involves the head and neck region with seldom involvement of mucosae, scalp, and ear lobes. We saw a 6-year-old child with multiple hyperpigmented verrucous plaques predominantly present over left half of the body, ipsilateral alopecia scalp, and verrucous lesions involving mucosae of palate and tongue, which were present bilaterally. Previously, case reports of oral lesions related to VEN had demonstrated segmental, midline, or unilateral distribution. Hereby, we report this peculiar case of Nevus Unius Lateris with bilateral oral mucosal involvement, owing to its rarity.

Verrucous epidermal nevus (VEN) is a benign skin disease that seriously affects appearance. Numerous therapeutic methods have been tried with varying results. However, there are few reports on the treatment of VEN by photodynamic therapy (PDT). This study aimed to evaluate the efficacy and adverse effects of 5‐aminolevulinic acid (ALA)‐PDT in VEN treatment with a long‐term follow‐up. A total of 16 patients with VEN received ALA‐PDT and were followed up for more than 1 year to observe the treatment effects, adverse reactions, and patients' satisfaction. Complete improvement of lesions was observed in 11 patients (three to six sessions of ALA‐PDT). Two patients obtained 90–99% improvement (five sessions) and 50–89% improvement in three patients (three to six sessions). They were satisfied with the treatment effects, with an average satisfaction of 4.19/5 (±0.91). Long‐term follow‐up ranging 14–50 months showed a low recurrence rate (2/16) and no scar left after ALA‐PDT. The results demonstrate that ALA‐PDT is an effective and safe therapy in treating VEN with mild adverse reactions and a low risk of scar formation. [ABSTRACT FROM AUTHOR]

Verrucous epidermal nevi (VEN) are cutaneous hamartomas characterized by keratinocytic hyperplasia. Majority are linear in distribution and tend to follow the Blaschko lines; however, some may have zosteriform (segmental) or systematized distribution involving widespread areas of skin. The systematized ones are further classified into "Nevus Unius Lateris" when one-half of the body is affected, and "Ichthyosis Hystrix" showing bilateral distribution, both being the uncommon forms. Although it can affect any body part, it rarely involves the head and neck region with seldom involvement of mucosae, scalp, and ear lobes. We saw a 6-year-old child with multiple hyperpigmented verrucous plaques predominantly present over left half of the body, ipsilateral alopecia scalp, and verrucous lesions involving mucosae of palate and tongue, which were present bilaterally. Previously, case reports of oral lesions related to VEN had demonstrated segmental, midline, or unilateral distribution. Hereby, we report this peculiar case of Nevus Unius Lateris with bilateral oral mucosal involvement, owing to its rarity. [ABSTRACT FROM AUTHOR]

Background: Patients with epidermal nevi strongly demand cosmetic improvement. Laser treatment appears appealing and is frequently used in clinical practice. Nevertheless, large series with long-term follow-up are missing, preventing definitive conclusions about its real benefit.Objective: To evaluate the long-term effectiveness and safety of lasers for epidermal nevi.Methods: Bicentric, retrospective, cohort study, including all patients treated with a laser for an epidermal nevus with more than a 1-year follow-up.Results: Seventy patients were treated for different types of epidermal nevi, mostly with ablative lasers: 23 verrucous epidermal nevi, 16 nevi sebaceous, 26 Becker nevi, 2 inflammatory linear verrucous epidermal nevi, 1 smooth-muscle hamartoma, 1 rounded and velvety epidermal nevus, and 1 nevus lipomatosus superficialis. The follow-up period was a median of 37 months (range, 12-127 months). Better results, fewer recurrences, and higher patient satisfaction were noted in treatments for verrucous epidermal nevi than for nevi sebaceous. Q-switched lasers failed to show any degree of improvement in almost all patients with Becker nevus.Limitations: The retrospective nature of the study.Conclusions: Ablative lasers can treat verrucous epidermal nevi with good long-term esthetic results but have limited long-term efficacy for nevus sebaceous. Q-switched lasers failed to improve Becker nevi. [ABSTRACT FROM AUTHOR]

Verrucous epidermal nevus is the most common form of epidermal nevi with usual onset at birth or early life. Adult onset is rare, and we report a case of verrucous epidermal nevi with onset in the fourth decade, dermatoscopy and histopathology of which were consistent with verrucous epidermal nevi.

Melorheostosis (MEL) is a rare benign bone disorder that can be associated with several anomalies, including vascular abnormalities, nevus sebaceus, unilateral nevoid telangiectasia, linear scleroderma and hypertrichosis. We report the case of a 6‐year‐old patient who showed an unusual co‐occurrence of bone hyperostosis and different skin lesions affecting the same side of the body: MEL, verrucous epidermal nevus, connective tissue nevus, linear scleroderma‐like disorder, hyperpigmentation and hypertrichosis. The spatial co‐occurrence of these conditions made us speculate as to whether they originated from a common genetic mechanism or if their co‐occurrence was completely accidental. [ABSTRACT FROM AUTHOR]

We present a clinical case of ichthyosis hystrix, a rare genetic ichthyosiform dermatosis. Specifics of the disease are related to the complexity of differential diagnosis and verification of the diagnosis, because clinical manifestation of ichthyosis hystrix is similar with that of verrucous epidermal nevus. Clinical particulars of both nosologies are characterized by bizarre and widespread skin lesions of spicular hyperkeratotic growth, located along Blaschko lines. The exclusive feature of the clinical case described is a long-term (20 years) clinical and laboratory monitoring of the patient. The literature review provides brief information on etiology, pathogenesis, clinical features, differential diagnosis, and pathomorphology of ichthyosis hystrix and verrucous epidermal nevus.

Background/aim: Verrucous epidermal nevi are cutaneous hamartomas with many clinical variants. Dermoscopic features of verrucous epidermal nevus have rarely been investigated. We aimed to identify dermoscopic findings of the entity which will facilitate the diagnostic process by reducing the use of invasive diagnostic methods. Materials and methods: The study included the patients with histopathologically approved verrucous epidermal nevus. Clinical, dermoscopic, and histopathological features of the patients were retrospectively reviewed and the findings identified were recorded. Dermoscopic examination was performed with a polarized-light handheld dermoscope with 10-fold magnification. Results: The most common dermoscopic features were thick brown circles, thick brown branched lines, and terminal hairs. The most common vessel pattern was dotted vessels. Branched thick brown lines, brown globules, brown dots forming lines, serpiginous brown dots, white and brown exophytic papillary structures, fine scale, thick adherent scale, and cerebriform structures were the other findings. Conclusion: We observed many vascular and nonvascular dermoscopic findings which were not described previously for the entity. Dermoscopic examination of the verrucous epidermal nevi may lead to more reliable clinical interpretation and thus may reduce the need for histopathological investigation. [ABSTRACT FROM AUTHOR]

Verrucous epidermal nevi (VEN) are benign congenital hamartomas consisting of keratinocytes. Histological examination mostly exhibits hyperkeratosis, acanthosis, papillomatosis and, rarely, the features of epidermolytic hyperkeratosis (EHK). We report a case of a 6-year-old boy who presented at Aga Khan University Hospital, Karachi, Pakistan with bilaterally symmetrical linear epidermal nevi following Blaschko's lines and showing epidermolytic hyperkeratosis on histology. The patient was treated with topical keratolytics and emolients which led to considerable improvement. To the best of the authors' knowledge, this is the first report of VEN from Pakistan. [ABSTRACT FROM AUTHOR]

Locus minoris resistentiae (LMR) is a site of the body that offers lesser resistance than the rest of the body to the onset of disease. It can be congenital or acquired. Areas of cutaneous mosaicism such as epidermal nevi can act as congenital LMR, leading to the development of inflammatory skin conditions or skin tumors on these. The occurrence of an infectious condition such as warts over nevi is rare. We report three cases of verrucous epidermal nevi (VENs) with the development of verrruca overlying the nevus later in life. The three patients had VEN on forehead, preauricular, and presternal area, respectively, since birth, with development of a warty lesion overlying these a few months before presenting to us. Skin biopsy and histopathological examination of the linear verrucous lesion were suggestive of VEN with hyperkeratosis, thickened epidermis, and papillomatosis. There was no evidence of epidermolytic hyperkeratosis or increased sebaceous glands in the dermis. Biopsy of the new warty lesion showed findings of verruca in all the patients. With the above findings, a diagnosis of verruca superimposed on linear VEN was made in all the three cases. The warts were removed by electrofulguration. Several acquired skin disorders, including inflammatory dermatoses, adnexal disorders, and neoplasms, have been shown to occur superimposed on epidermal or sebaceous nevus. Ours is probably the first ever description of a wart occurring on VEN. [ABSTRACT FROM AUTHOR]

The verrucous epidermal nevus (VEN) is the most common type of epidermal nevi. As lesions can be disfiguring, treatment is often sought. Many therapeutic approaches have been reported, with variable efficacy and safety. Picosecond (PS) lasers are novel laser devices designated to target small chromophores. A side effect of these lasers is blistering due to epidermal-dermal separation. We aimed to harness this side effect of the PS lasers to treat patients with VEN. The purpose of this study was to report our experience treating VEN using a PS 532-nm laser. We present a retrospective case series of six patients with large VEN who were treated using a PS 532-nm laser (2-6 treatments, 8-10 weeks apart). Response in clinical photographs was assessed by two independent dermatologists and graded on a scale of 0 (exacerbation) to 4 (76-100% improvement). Patient satisfaction was recorded on a scale of 1-5. All patients demonstrated significant improvement. Average improvement was 3.7 on the quartile scale of improvement. Patient satisfaction rate averaged 4.7. The PS 532-nm laser is a promising novel modality for the treatment of large VEN. [ABSTRACT FROM AUTHOR]

The Author reported two cases of sebaceous nevus characterized by the hyperproduction of melanin, in the first case histologically proven by the presence of a melanin excess in the basal layer of the epidermis, in the second case dermatoscopically hypothesized due to the presence of brownish dots and globules. Being absent at birtht the overproduction of melanin occurred in the peripuberal period suggesting a role of hormonal factors. In the first case, the physical examination was reminiscent of melanoma; however, the careful evaluation of the history, physical examination and dermatoscopic findings led to exclude this hypothesis. [ABSTRACT FROM AUTHOR]

Background: A verrucous epidermal nevus (VEN) is a skin disorder that has been treated using different treatment modalities with varying results. Ablative lasers such as carbon dioxide laser (CO2) and erbium:yttrium– aluminum–garnet (Er:YAG) laser have been considered as the gold standard for the treatment of epidermal nevi. Objective: To evaluate and compare the efficacy, postoperative wound healing and side effects of pulsed CO2 laser and Er:YAG laser for the treatment of verrucous epidermal nevi. Materials and methods: Twenty patients with localized VEN were randomly divided into two groups. Group 1 was administered CO2 laser and group 2 underwent Er:YAG laser treatment. A blinded physician evaluated the photographs and dermoscopic photomicrographs for the efficacy and possible side effects. All patients received one treatment session and were followed up over a 6-month period. Results: Both lasers induced noticeable clinical improvement, but there were no significant differences between two lasers in treatment response, patient satisfaction, duration of erythema and side effects. The average time to re-epithelialization was 13.5 days with CO2 and 7.9 days with Er:YAG laser (p<.0005). No scarring was observed in Er:YAG laser group and no lesional recurrence was detected in CO2 laser group since treatment. Conclusion: Apart from re-epithelialization, both lasers showed equivalent outcomes with respect to treatment response, patient satisfaction, side effects and complications. [ABSTRACT FROM AUTHOR]

Verrucous epidermal nevus (VEN) is a skin disorder that commonly presents at birth; it is characterized by skin-colored to brown verrucous papules in a linear distribution following Blaschko's lines. Even though it is extremely rare, VEN has been associated with malignant transformation. VEN has been treated by different treatment modalities with varying and frustrating results. We introduce a new type of treatment. The fractional micro-plasma radio-frequency (RF) technology, which uses unipolar RF technology to provoke plasma spars, creating multiple controlled micro-perforations on the skin. Photodynamic therapy (PDT) is a type of technology for disease diagnosis and treatment, in which a photosensitizer gathers within the nidus and kills the diseased cells. In this report, we present a case of VEN that was successfully treated with fractional micro-plasma RF technology and PDT without side effects or complications; a follow-up was conducted after 24 months and no signs of recurrence were observed. [ABSTRACT FROM AUTHOR]

Verrucous epidermal nevus (VEN) is a common type of keratinocyte hamartoma present at birth or occurring later in life. It is seen at any site, but is less common on the head and neck, rarely seen on the face and very rarely involves the oral mucosa. Widespread multiple epidermal nevi may reflect genetic or chromosomal mosaicism. Blaschko has documented characteristic linear, zosteriform, unilateral or systematized patterns with streaks and swirls. They are resistant to treatment with risk of recurrence. A case of male child is presented here with extensive VEN with involvement of ear lobe and scalp of left side with cicatricial alopecia. Patient had delayed milestone development without any systemic involvement. [ABSTRACT FROM AUTHOR]

Epidermal nevi are nevus lesions consisting of any component of the epidermis including adnexal structures. They are classified according to the clinical and pathological findings, the extent of skin involvement, presence of inflammation and possible involvement of other organs. The lesions are benign but require treatment for cosmetic purposes. Here we are reporting a case of systematized verrucous epidermal nevus in a six years old female child. [ABSTRACT FROM AUTHOR]

Verrucous epidermal nevus (VEN) are keratinocytic epidermal nevus that appear at birth or in early childhood. They exhibit a range of manifestations, depending on the patient's age. VEN are rarely encountered in clinical practice, and the systemic and comprehensive clinical characteristics of VEN have not been well investigated. Furthermore, the association between tandem mass tag (TMT)-based quantitative proteomics and the VEN phenotype is still unclear. This study investigated the differences in the clinical characteristics and lesion proteomics between inflammatory linear VEN (ILVEN) and local VEN. This retrospective study enrolled 125 patients with histopathologically diagnosed VEN who presented to our hospital between 2019 and 2021. We collected the clinical data of all patients with VEN using a self-designed questionnaire. The expression of proteins in VEN lesions was analyzed using TMT proteomics technology. In total, there were 125 patients with VEN that were evaluated, including 67 (53.60%) patients with local VEN and 58 (46.40%) with ILVEN. No significant differences were found in sex, onset age, and lesion location between patients with local VEN and those with ILVEN (all P > 0.05). Significant differences were found in the onset site and pruritus scores between patients with ILVEN and those with local VEN (all P < 0.05). According to the TMT proteomics results, 89 proteins were up or downregulated with at least 1.3-fold (upregulated: 38, downregulated: 51; P < 0.05) in ILVEN lesions relative to VEN lesions. The top 10 differentially expressed proteins between ILVEN and local VEN lesions were OGN, NT5C3A, ADD1, OLFML1, DHRS1, CALML5, SAMHD1, SFRP2, SPRR1B, and SERPINB13. The upregulated proteins are mainly involved in neutrophil activation, neutrophil-mediated immunity, and p53 signaling pathway (hsa04115). The downregulated proteins are mainly involved in cellular response to cytokine stimulus, cell adhesion, Th1 and Th2 cell differentiation. In total, based on the differentially expressed proteins between ILVEN and local VEN, five pathways that may be associated with the pathogenesis of inflammation, including CAMs (P = 0.006), Th1 and Th2 cell differentiation (P = 0.017), PPAR signaling pathway (P = 0.023), Th17 cell differentiation (P = 0.024), and p53 signaling pathway (P = 0.041). Clinical data of the patients revealed that ILVEN lesions presented with intense pruritus and inflammatory change. Differentially expressed proteins between ILVEN and local VEN are mainly involved in multiple inflammation related pathways associated with the pathogenesis mechanisms of pruritus. The small sample size in clinical characteristic and proteomics study is one of the most significant limitations in our study. The inflammation associated proteins and signal pathways in the pathogenesis of pruritus in ILVEN is not explored. In this study, we found the lesions of ILVEN patients presented with intense pruritus and inflammational change. A total of 89 proteins were up or downregulated with at least 1.3-fold (upregulated: 38, downregulated: 51; P < 0.05) in ILVEN lesions relative to VEN lesions. On the other hand, the etiology of itch in ILVEN mainly associated with inflammation, but the exact mechanisms was still unclear. We found the differentially expressed proteins between ILVEN and local VEN enriched five pathways that may be associated with the pathogenesis of inflammation and pruritus. [Display omitted] In the past decades, no large scale study has documented the clinical characteristics of ILVEN and local VEN. Furthermore, the association between tandem mass tag (TMT)-based quantitative proteomics and the VEN phenotype is still unclear. In our previous reported, we applied TMT-based proteomics methods to analyze the proteins differences between VEN lesions and normal skin tissues. Therefore, in this study, we found the: • Significant differences were found in onset site and pruritus scores between patients with ILVEN and those with local VEN. • A total of 89 proteins were up or downregulated with at least 1.3-fold in ILVEN lesions relative to VEN lesions. • The enriched five pathways that may be associated with the pathogenesis of inflammation and pruritus in ILVEN. [ABSTRACT FROM AUTHOR]

The article presents abstracts of poster presentations on dermatology, including topics on newborn skin disorders in a dermatology outpatient clinic in Turkey, influence of neonatal and maternal factors on the prevalence of salmon patch, and treatment of diffuse cutaneous mastocytosis with imatinib mesylate.

Competing Interests: Competing interests: None.

Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) is a rare variant of porokeratosis with characteristic histological feature of cornoid lamella involving the acrosyringium. We report a classic case of a 20-year-old male, who clinically presented to us with keratotic papules and plaque with pits, few having comedo like plugs, on right palm and sole since 1 year of age. A punch biopsy from palm was diagnostic as well as confirmatory showing cornoid lamella involving an eccrine duct which is the characteristic histopathological feature of PEODDN. [ABSTRACT FROM AUTHOR]

Competing Interests: Competing interests: The authors have no conflicts of interest to disclose.

Summary: An 81-year-old African American female presented with a 3-year history of a slow, persistently enlarging mass on the medial aspect of her left thigh. Her past history was remarkable for a congenital linear epidermal naevus that was present on the inner aspect of her left thigh. A biopsy of the mass was performed and histology results confirmed the diagnosis of a well differentiated squamous cell carcinoma. Such an occurrence is extremely rare and less than 10 cases have been reported in the literature. [Copyright &y& Elsevier]