Linear verrucous epidermal nevus: Difference between revisions

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'''Linear verrucous epidermal nevus''' (LVEN) is a rare skin condition characterized by the presence of well-demarcated, linear, verrucous (wart-like) plaques that follow the lines of [[Blaschko's lines|Blaschko]]. These lesions are benign but can be associated with significant cosmetic concerns and, in some cases, other systemic manifestations. The condition is congenital, meaning it is present at birth, but may not become apparent until later in childhood or even adulthood.
{{SI}}
 
{{Infobox medical condition
==Etiology and Pathogenesis==
| name            = Linear verrucous epidermal nevus
The exact cause of linear verrucous epidermal nevus is not fully understood. It is believed to result from somatic mutations that occur during embryonic development, leading to mosaicism. These mutations affect the normal development of the [[epidermis]], resulting in the characteristic lesions. Unlike other forms of [[epidermal nevus syndrome]], LVEN is not typically associated with systemic abnormalities.
| image          = [[File:SkinTumors-P5280048.JPG|left|thumb|Linear verrucous epidermal nevus]]
 
| caption        = Linear verrucous epidermal nevus on the skin
==Clinical Features==
| synonyms        = Verrucous epidermal nevus
Linear verrucous epidermal nevus typically presents as skin-colored to brown, verrucous (wart-like), linear plaques. These plaques strictly follow the lines of Blaschko, which are invisible lines on the skin representing pathways of embryonic cell migration. The lesions can vary in size and thickness and are most commonly found on the trunk and extremities. Although LVEN is usually asymptomatic, lesions can become irritated or infected, leading to discomfort.
| field          = [[Dermatology]]
 
| symptoms        = [[Wart]]-like lesions, [[hyperkeratosis]], [[pruritus]]
| complications  = [[Secondary infection]], [[malignant transformation]]
| onset          = [[Childhood]]
| duration        = [[Chronic (medicine)|Chronic]]
| causes          = [[Genetic mutation]]
| risks          = [[Genetic predisposition]]
| diagnosis      = [[Clinical diagnosis]], [[skin biopsy]]
| differential    = [[Verrucous carcinoma]], [[psoriasis]], [[lichen planus]]
| treatment      = [[Topical treatment]], [[surgical excision]], [[laser therapy]]
| medication      = [[Keratolytics]], [[retinoids]]
| frequency      = Rare
}}
{{Short description|A type of skin lesion}}
'''Linear verrucous epidermal nevus''' (LVEN) is a type of [[epidermal nevus]] characterized by a linear arrangement of [[verrucous]] skin lesions. These lesions are typically present at birth or develop in early childhood and are caused by a genetic mosaicism.
==Presentation==
Linear verrucous epidermal nevus presents as a series of [[hyperkeratotic]] and [[verrucous]] papules that coalesce into linear plaques. These lesions follow the lines of [[Blaschko's lines]], which are patterns of skin cell development. The lesions are often [[hyperpigmented]] and can vary in color from light brown to dark brown or black.
==Pathophysiology==
LVEN is caused by a postzygotic mutation leading to genetic mosaicism. This results in a localized area of skin cells that proliferate abnormally, forming the characteristic lesions. The exact genetic mutations involved can vary, but they often affect genes related to skin cell growth and differentiation.
==Diagnosis==
==Diagnosis==
The diagnosis of linear verrucous epidermal nevus is primarily clinical, based on the characteristic appearance and distribution of the lesions. In uncertain cases, a [[skin biopsy]] may be performed to confirm the diagnosis. Histologically, LVEN shows hyperkeratosis, papillomatosis, and acanthosis, which are typical features of verrucous epidermal nevi.
Diagnosis of linear verrucous epidermal nevus is primarily clinical, based on the appearance and distribution of the lesions. A [[skin biopsy]] may be performed to confirm the diagnosis and rule out other conditions. Histologically, the lesions show [[acanthosis]], [[hyperkeratosis]], and papillomatosis.
 
==Management==
==Treatment==
Management of LVEN is often conservative, as the lesions are benign. However, treatment may be sought for cosmetic reasons or if the lesions become symptomatic. Options include:
There is no cure for linear verrucous epidermal nevus, and treatment is aimed at managing symptoms and improving cosmetic appearance. Options include topical treatments, such as [[retinoids]] and [[keratolytics]], and procedural interventions like [[laser therapy]], [[cryotherapy]], and [[surgical excision]]. The choice of treatment depends on the extent and location of the lesions, as well as the patient's preferences and tolerance for potential side effects.
* [[Topical treatments]] such as [[keratolytics]] or [[retinoids]]
 
* [[Cryotherapy]]
* [[Laser therapy]]
* [[Surgical excision]]
==Prognosis==
==Prognosis==
The prognosis for individuals with linear verrucous epidermal nevus is generally good, as the condition is benign. However, the cosmetic appearance of the lesions can be a significant concern for affected individuals, potentially leading to psychological distress. Regular follow-up with a dermatologist is recommended to monitor for any changes in the lesions and to manage any associated symptoms.
The prognosis for individuals with linear verrucous epidermal nevus is generally good, as the condition is benign. However, there is a small risk of [[malignant transformation]] in long-standing lesions, so regular monitoring is recommended.
 
==See also==
==See Also==
* [[Epidermal nevus]]
* [[Epidermal nevus syndrome]]
* [[Blaschko's lines]]
* [[Blaschko's lines]]
* [[Skin biopsy]]
* [[Genetic mosaicism]]
 
[[Category:Dermatology]]
[[Category:Dermatology]]
[[Category:Congenital disorders]]
[[Category:Skin conditions resulting in tumors]]
[[Category:Skin conditions]]
 
{{Medicine-stub}}

Latest revision as of 01:13, 8 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Linear verrucous epidermal nevus
Linear verrucous epidermal nevus
Synonyms Verrucous epidermal nevus
Pronounce N/A
Specialty N/A
Symptoms Wart-like lesions, hyperkeratosis, pruritus
Complications Secondary infection, malignant transformation
Onset Childhood
Duration Chronic
Types N/A
Causes Genetic mutation
Risks Genetic predisposition
Diagnosis Clinical diagnosis, skin biopsy
Differential diagnosis Verrucous carcinoma, psoriasis, lichen planus
Prevention N/A
Treatment Topical treatment, surgical excision, laser therapy
Medication Keratolytics, retinoids
Prognosis N/A
Frequency Rare
Deaths N/A


A type of skin lesion


Linear verrucous epidermal nevus (LVEN) is a type of epidermal nevus characterized by a linear arrangement of verrucous skin lesions. These lesions are typically present at birth or develop in early childhood and are caused by a genetic mosaicism.

Presentation[edit]

Linear verrucous epidermal nevus presents as a series of hyperkeratotic and verrucous papules that coalesce into linear plaques. These lesions follow the lines of Blaschko's lines, which are patterns of skin cell development. The lesions are often hyperpigmented and can vary in color from light brown to dark brown or black.

Pathophysiology[edit]

LVEN is caused by a postzygotic mutation leading to genetic mosaicism. This results in a localized area of skin cells that proliferate abnormally, forming the characteristic lesions. The exact genetic mutations involved can vary, but they often affect genes related to skin cell growth and differentiation.

Diagnosis[edit]

Diagnosis of linear verrucous epidermal nevus is primarily clinical, based on the appearance and distribution of the lesions. A skin biopsy may be performed to confirm the diagnosis and rule out other conditions. Histologically, the lesions show acanthosis, hyperkeratosis, and papillomatosis.

Management[edit]

Management of LVEN is often conservative, as the lesions are benign. However, treatment may be sought for cosmetic reasons or if the lesions become symptomatic. Options include:

Prognosis[edit]

The prognosis for individuals with linear verrucous epidermal nevus is generally good, as the condition is benign. However, there is a small risk of malignant transformation in long-standing lesions, so regular monitoring is recommended.

See also[edit]

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