Unilateral palmoplantar verrucous nevus

Unilateral palmoplantar verrucous nevus
Synonyms
Pronounce	N/A
Specialty	Dermatology
Symptoms	Wart-like lesions on one side of the body, typically on the palms or soles
Complications	N/A
Onset	Usually present at birth or develops in early childhood
Duration	Long-term
Types	N/A
Causes	Unknown
Risks
Diagnosis	Clinical examination, biopsy
Differential diagnosis	Epidermal nevus, verruca vulgaris, palmoplantar keratoderma
Prevention	N/A
Treatment	Topical treatment, cryotherapy, laser therapy
Medication	N/A
Prognosis	Generally good, but lesions may persist
Frequency	Rare
Deaths	N/A

Unilateral palmoplantar verrucous nevus is a rare dermatological condition characterized by the presence of wart-like lesions on the palms and soles, typically affecting only one side of the body. This condition is a type of epidermal nevus, which is a benign growth of the skin.

Presentation

The condition manifests as thickened, verrucous (wart-like) plaques that are confined to the palm and/or sole of one side of the body. These lesions are usually present at birth or develop in early childhood. The affected skin may appear hyperkeratotic and can sometimes be painful, especially when pressure is applied, such as during walking.

Pathophysiology

Unilateral palmoplantar verrucous nevus is thought to result from a postzygotic somatic mutation, leading to mosaicism. This means that the genetic mutation is present in only a portion of the body's cells, which explains the localized nature of the lesions. The exact genetic mutations involved are not fully understood, but they are believed to affect the keratinocytes, the predominant cell type in the epidermis.

Diagnosis

Diagnosis is primarily clinical, based on the characteristic appearance and distribution of the lesions. A skin biopsy may be performed to confirm the diagnosis and rule out other conditions such as verruca vulgaris (common warts) or palmoplantar keratoderma. Histological examination typically shows hyperkeratosis, acanthosis, and papillomatosis.

Treatment

Treatment options are limited and primarily aimed at managing symptoms. Topical keratolytics, such as salicylic acid, can be used to reduce hyperkeratosis. In some cases, surgical removal or laser therapy may be considered, although recurrence is common. Regular follow-up with a dermatologist is recommended to monitor the condition.

Prognosis

The condition is benign and does not typically lead to serious health issues. However, the lesions can be cosmetically concerning and may cause discomfort. The prognosis is generally good, with management focused on symptom relief.

Related pages

• Epidermal nevus
• Verruca vulgaris
• Palmoplantar keratoderma