Verrucous nevus

Verrucous Nevus is a rare skin condition characterized by the appearance of warty, verrucous lesions that are often present at birth or develop during childhood. This condition falls under the broader category of epidermal nevi, which are non-cancerous (benign) growths that result from an overgrowth of the epidermis, the outermost layer of the skin. Verrucous nevus is particularly noted for its rough, raised texture, resembling that of a wart.

Etiology and Pathogenesis

The exact cause of verrucous nevus is not fully understood, but it is believed to result from somatic mutations that occur during embryonic development. These mutations lead to an abnormal proliferation of keratinocytes, the predominant cell type in the epidermis. Unlike genetic mutations, somatic mutations are not inherited but occur after conception.

Clinical Features

Verrucous nevus can vary greatly in size, shape, and location on the body. The lesions are typically well-demarcated, verrucous (wart-like), and may cover large areas of the body. In some cases, the nevus may be linear, following the lines of Blaschko's lines, which are invisible lines on the skin that represent pathways of embryonic cell migration. The color of the lesions can range from skin-colored to darker pigmentation.

Diagnosis

Diagnosis of verrucous nevus is primarily clinical, based on the appearance of the skin lesions. In uncertain cases, a biopsy may be performed to examine the histological characteristics of the nevus. Histologically, verrucous nevus shows hyperkeratosis, acanthosis, and papillomatosis, which are indicative of the thickened, wart-like appearance of the skin.

Treatment

Treatment options for verrucous nevus are limited and focus on improving cosmetic appearance and managing symptoms, if present. Options may include topical treatments, laser therapy, or surgical removal. However, complete removal can be challenging, especially for large or widespread lesions, and there is a risk of recurrence.

Prognosis

The prognosis for individuals with verrucous nevus is generally good, as it is a benign condition. However, the cosmetic and psychological impact can be significant, especially for extensive lesions. There is a very low risk of malignant transformation.

See Also

• Epidermal nevus syndrome
• Skin lesion
• Keratinocyte

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