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An inflammatory linear papillary epidermal nevus is an inflammatory epidermal nevus. Most lesions occur sporadically, but family cases have also been described, more often they affect girls (4: 1), onset usually before the age of 2. but it can appear later in life (even in adults). The cause of the ailments are somatic mutations.
Inflammatory linear papillary epidermal nevus – definition
The ailment in the form of an inflammatory linear papillary epidermal nevus was first described in 1863 by Baerensprung. The disease is characterized by the presence of birthmarks or those acquired in childhood. Most changes occur sporadically, but family cases have also been described, more often they affect girls (4: 1), onset usually before the age of 2. but it can appear later in life (even in adults). The skin lesions appear as areas of over-pigmentation that do not stick out above the skin surface. These can be skin-colored spots or papules that develop into a papillary form as they grow.
Causes of the inflammatory linear papillary epidermal nevus
The cause of the disease is considered to be somatic mutations that lead to genetic defects characterized by the presence of two or more heterogeneous cells developing around one zygote.
Symptoms of inflammatory epidermal moles
Papillary nevi can be located anywhere on the skin, even in the genitourinary and anal area. Most often, skin eruptions appear on:
- face
- neck,
- torso,
- limbs,
- hairy scalp.
Linear papillary birthmarks are most often lesions of a linear and one-sided arrangement, and what is important – they do not exceed the midline of the body. They can appear singly as warts or multiply, spreading to larger areas of the skin and lasting throughout life. Epidermal moles usually appear in early childhood and develop with the patient. They resemble the skin changes occurring in psoriasis (similar histopathological picture) accompanied by troublesome itching.
The ailment may worsen, then we are talking about an inflammatory, linear papillary epidermal nevus. In its course, the patient is accompanied by burning, pain and erosions. In rare cases, a nevus may develop a neoplasm, such as basal cell carcinoma, squamous cell carcinoma, or keratoacanthoma.
Clinical variants of epidermal nevi
1. Hard papillary nevus – is usually located on the trunk and limbs; it is characterized by flat-elevated changes in skin color and has a papillary surface.
2. Soft papillary epidermal nevus – it is usually small, its color is flesh-colored or gray with a soft surface; the individual papules form clusters resembling senile warts.
3. Inflammatory linear papillary epidermal nevus – it is a characteristic form of an epidermal nevus that coexists with inflammation and persistent itching; this ailment is especially exacerbated in the form of psoriasis-like disease; the lesions are linear itchy erythematous lesions resembling psoriasis lesions. Common symptoms to help diagnose this form include: early onset (before age five); itching; location on the left lower limb and buttocks; more common in women; a histopathological picture similar to that of psoriasis, moreover, an epidermal hypertrophy resembling psoriasis is visible. Inflammatory nevus is resistant to treatment and does not have the ability to resolve spontaneously.
4. CHILD epidermal nevus – for this ailment, the following are characteristic: unilateral ichthyosis erythroderma, hemidysplasia and limb defects. The lesions are located on one side and usually do not exceed the midline of the body. CHILD nevi are erythematous foci covered with hyperkeratotic scales and horn plugs. This condition affects only the female sex, as the gene responsible for its occurrence is present on the X chromosome.
5. Horny nevus – is the rarest form of an epidermal nevus, characterized by hyperkeratosis and the formation of thick, growth-like warts.
It is very important to differentiate inflammatory linear papillary epidermal nevi from other ailments, for example:
- banded lichen;
- papillary lichen planus;
- papillary neurodermatitis.
Inflammatory linear papillary epidermal nevus and treatment
Epidermal nevi is a condition that accompanies the patient throughout his life and there is no possibility of their spontaneous regression. They are primarily a cosmetic defect, especially when present in visible places, such as the face and neck. Inflammatory linear papillary epidermal moles are treated for aesthetic reasons.
Among the methods of treating epidermal moles, the following are distinguished:
- surgical removal of the lesion (scars remain),
- dermabrasion,
- electrocoagulation,
- cryotherapy,
- calcipotriol,
- keratolytic drugs,
- dye laser,
- laser CO2,
- tertiary,
- acitretin,
- ditranol,
- podophyllin.
Surgical removal of the lesion is still considered the most effective method of treatment, but it is sometimes necessary to perform a transplant to fill a free defect. It is associated with scarring. The use of a laser gives good treatment results – moles can be treated with the Er: YAG pulsed laser, the wave of which has the properties of a strong impact through water contained in the tissue (similar to a CO2 laser). Thermal damage is small, and thus the risk of scarring is minimized. After using the laser, wounds heal faster, but the best effects are visible after using it on superficial changes.
Lit.: [1] Sotiriadis D., Patsatsi A., Lazaridou E. i wsp.: Is inflammatory linear verrucous epidermal naevus a form of linear naevoid psoriasis? J Eur Acad Dermatol Venereol 2006, 20; 483-4. [2] Hofer T.: Does infl ammatory linear verrucous epidermal nevus represent a segmental type 1/type 2 mosaic of psoriasis? Dermatology 2006, 212; 103-7.
Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House