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THROUGH THE DERMATOSCOPE
Year : 2017  |  Volume : 8  |  Issue : 5  |  Page : 388-389  

Dermoscopy of nevus comedonicus


Department of Dermatology and Venereology, Pramukhswami Medical College, Karamsad, Gujarat, India

Date of Web Publication15-Sep-2017

Correspondence Address:
Rita V Vora
Department of Dermatology and Venereology, Pramukhswami Medical College, Karamsad - 388 325, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/idoj.IDOJ_430_16

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How to cite this article:
Vora RV, Kota RS, Sheth NK. Dermoscopy of nevus comedonicus. Indian Dermatol Online J 2017;8:388-9

How to cite this URL:
Vora RV, Kota RS, Sheth NK. Dermoscopy of nevus comedonicus. Indian Dermatol Online J [serial online] 2017 [cited 2020 Apr 2];8:388-9. Available from: http://www.idoj.in/text.asp?2017/8/5/388/214726

A 29-year female presented to the skin outpatient department with asymptomatic lesions over the left side of the face and neck since 18 years. Initially, the lesions were gradually progressive, but had remained stable since the past 10 years. There was no history of trauma or irritation or a familial history of similar lesions. Cutaneous examination revealed multiple, comedone-like lesions over the left side of the neck following Blaschko's lines and extending from the preauricular region to the upper neck in a U shape [Figure 1]. There were no lesions elsewhere on the body. Mucosae, hair, and nails were unaffected. General physical, ophthalmic, and systemic examination were normal. There were no double comedones, sinus tract, or scarring. There was no other abnormality. Routine laboratory investigations including complete blood count, blood chemistry, and urinalysis were within normal limits. Dermoscopy (Dino-Lite premier AM3013T nonpolarized, Contact type; ×50 magnification, connected to a computer with inbuilt camera for taking photographs) of the lesion showed multiple, well-defined, structure-less brown homogenous circular areas surrounding the keratin plugs [Figure 2]. Histological examination of the lesion revealed deep invagination of the epidermis containing abundant keratin resembling dilated hair follicles and papillary dermis showed mild perivascular lymphocytic cell infiltrate [Figure 3] and [Figure 4]. These features were suggestive of nevus comedonicus. Spiewek et al. described dermatoscopic findings of nevus comedonicus as numerous circular and barrel-shaped homogenous areas in light and dark-brown shades with remarkable keratin plugs.[1] Dermoscopy is useful in differentiating nevus comedonicus from comedones of acne, other rare epidermal nevi, such as sebaceous nevus, and hair follicle nevus. Comedones of acne vulgaris show numerous, homogenous areas, light and dark-brown, sometimes black in color, depending on the type of acne, open or closed comedones, predominantly circular, and situated superficially on dermoscopy.[1] Sebaceous nevus shows bright, yellow dots which are not associated with hair follicles. Many follicular openings and interfollicular “pseudo-pigment network” on dermoscopy characterize hair follicle nevus.[1] Atrophoderma vermiculatum usually presents as reticulated depressions with narrow ridges of normal-appearing skin, giving a worm-eaten appearance, whereas in nevus comedonicus syndrome, the interfollicular skin is typically normal.[2] Thus, dermoscopy is a useful tool in not only diagnosing nevus comedonicus but also in differentiating it from various other dermatoses.
Figure 1: Multiple comedone-like lesions over the left side of the neck following Blaschko's lines extending from the preauricular region to the upper neck in a U shape

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Figure 2: Dermoscopy (nonpolarized × 50) showing multiple, well-defined, structure-less, brown homogenous circular areas (blue arrows) surrounding the keratin plugs (black arrows)

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Figure 3: (H and E stain, ×10) showing deep invagination of the epidermis containing abundant keratin resembling dilated hair follicles and papillary dermis showing mild perivascular lymphocytic cell infiltrate

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Figure 4: Histopathology image for reviewing purpose.legend:Dilated hair follicle with abundant flaky keratin material and a mild perivascular infiltrate in the superficial dermis. (H and E stain, x40)

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Financial support and sponsorship

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Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Śpiewak R, Winciorek G. Dermoscopy on nevus comedonicus: A case report and review of the literature. Postep Derm Alergol 2013;4:252–4.  Back to cited text no. 1
    
2.
Pavithra S, Pai H, Mallya H, Pai GS. Nevuscomedonicus Syndrome. Indian J Dermatol 2011:56:771-2.  Back to cited text no. 2
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]


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