Abstract

RINCON, Silvia et al. Inflammatory linear verrucous epidermal NEVUS (NILVEN) presenting in adulthood: Case report. AVFT [online]. 2014, vol.33, n.2, pp.64-68. ISSN 0798-0264.

Inflammatory Linear Verrucous Epidermal Nevus (ILVEN) is an infrequent histopathologic variant of epidermal nevus, characterized by papular-verrucous, descamative psoriasis- like lesions which tend to coalesce in plaques along Blaschko’s lines, with intense pruritus. This is a case report of a 35-year-old male patient who -over the course of 12 months-verrucous and papular coalescent lesions, over an erythematous foundation with severe descamation and pruritus, extending from the back of the left hand up to the ipsilateral scapular region, accompanied by several scratching excoriations. The biopsy report describes psoriasis-like epidermic hyperplasia, parakeratosis, orthokeratosis and hypergranulosis, as well as superficial dermis with liquenoid and perivascular lymphocyte infiltration, confirming the diagnosis of ILVEN. After starting treatment with topical retinoids, the patient exhibited several remissions and relapses of the lesions, which were sequentially managed with symptomatic treatment, including hydrating and relipidizing creams, topical spironolactone and mupirocin, oral H2 antagonists, and electrocauterization; over the course of 22 months, when total remission was achieved. Histopathologic diagnosis is fundamental in the characterization and distinction of ILVEN from other entities of similar clinical presentation, particularly linear psoriasis; and especially in atypical presentations, including adult age onset, male patients, localization in upper limbs -as described in this report- and affectation of the right hemibody.

Keywords : Inflammatory Linear Verrucous Epidermal Nevus; psoriasis; keratosis; histopathology.