Nevus Comedonicus Clinical Presentation

  • Author: Rossitza Lazova, MD; Chief Editor: William D James, MD   more...
 
Updated: May 11, 2012
 

History

The lesions are typically present at birth or develop in early childhood. They are usually asymptomatic. However, one case report described itching as an accompanying symptom. Patients usually seek help for cosmetic reasons. The lesions grow as the patient does and often grow faster at puberty. Patients may be able to express keratinaceous material from the pores.

With the inflammatory form, repeated bacterial infections, drainage, cysts, fistula and abscess formation, and scarring may develop.[7, 8, 9]

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Physical

The lesion appears as a collection of discrete, dilated follicular ostia plugged with pigmented keratinaceous material.[10, 11] They can be single or multiple, usually unilateral, and range in size from a few centimeters to involving half of the entire body.

Nevus comedonicus is typically found on the face, trunk, neck, and upper extremities.[12, 13, 14, 15] Rarely, it has been described on the palms[16] and soles or penis.[17] When it occurs on the elbows and knees, it can appear as verrucous nodules.

Nevus comedonicus may be linear, interrupted, unilateral, bilateral, present in a dermatomal distribution, following the lines of Blaschko, or segmental.[9, 18, 19, 20, 21, 22, 23]

Nevus comedonicus syndrome is the association of nevus comedonicus with abnormalities in the central nervous system, skeletal system, skin, and eyes, as follows:

  • Central nervous system - Epilepsy, electroencephalogram abnormalities, transverse myelitis, microcephaly
  • Skeletal system - Scoliosis, hemivertebrae, spina bifida occulta, foot deformities, absent fifth finger, syndactyly, supernumerary digits
  • Skin - Ichthyosis, trichilemmal cysts, leukoderma, white hairs, Sturge-Weber syndrome, hemangiomas, linear basal cell nevus
  • Eye - Congenital cataracts (unilateral and bilateral)[24]
  • Other - Bilateral oligodontia,[25] multiple basal cell carcinomas, rare systemic malignancies
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Causes

The cause is unknown.

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Contributor Information and Disclosures
Author

Rossitza Lazova, MD  Associate Professor of Dermatology and Pathology, Director of Dermatopathology Residency and Fellowship Program, Yale University School of Medicine; Consulting Pathologist/Dermatopathologist, Veterans Affairs Medical Center, West Haven, Connecticut

Rossitza Lazova, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and International Society of Dermatopathology

Disclosure: Nothing to disclose.

Specialty Editor Board

Barbara R Reed, MD  Clinical Professor, Department of Dermatology, Dermatology Service, Denver Veterans Affairs Medical Center, University of Colorado Health Sciences Center; Consulting Staff, Denver Skin Clinic

Disclosure: Nothing to disclose.

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD  Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Joseph J. Shaffer, MBBS, Vincent A. de Leo, MD, to the development and writing of this article.

References

  1. Kofmann S. A case of rare localization and spreading of comedones. Arch Dermatol Syphilol. 1895;32:177-8.

  2. Patrizi A, Neri I, Fiorentini C, Marzaduri S. Nevus comedonicus syndrome: a new pediatric case. Pediatr Dermatol. Jul-Aug 1998;15(4):304-6. [Medline].

  3. Engber PB. The nevus comedonicus syndrome: a case report with emphasis on associated internal manifestations. Int J Dermatol. Nov 1978;17(9):745-9. [Medline].

  4. Martinez M, Levrero P, Bazzano C, Larre Borges A, De Anda G. Nevus comedonicus syndrome in a woman with Paget bone disease and breast cancer: a mere coincidence?. Eur J Dermatol. Nov-Dec 2006;16(6):697-8. [Medline].

  5. Giam YC, Ong BH, Rajan VS. Naevus comedonicus in homozygous twins. Dermatologica. 1981;162(4):249-53. [Medline].

  6. Grimalt R, Caputo R. Posttraumatic nevus comedonicus. J Am Acad Dermatol. Feb 1993;28(2 Pt 1):273-4. [Medline].

  7. Vasiloudes PE, Morelli JG, Weston WL. Inflammatory nevus comedonicus in children. J Am Acad Dermatol. May 1998;38(5 Pt 2):834-6. [Medline].

  8. Kirtak N, Inaloz HS, Karakok M, Erguven HG, Ozgoztasi O. Extensive inflammatory nevus comedonicus involving half of the body. Int J Dermatol. Jun 2004;43(6):434-6. [Medline].

  9. Asokan N, Sridevi PK. Inflammatory nevus comedonicus in an infant. Indian J Dermatol Venereol Leprol.: Nov-Dec/2008. [Medline].

  10. Sikorski D, Parker J, Shwayder T. A boy with an unusual scalp birthmark. Nevus Comedonicus. Int J Dermatol. Jun 2011;50(6):670-2. [Medline].

  11. Arias-Santiago S, Aneiros-Fernandez J, Buendia-Eisman A, Giron-Prieto MS, Aneiros-Cachaza J. Unknown: A 5-year-old boy with comedo-like lesions on the right buttock. Dermatology Online Journal [serial online]. 16:11. Available from: http://dermatology.cdlib.org/1610/4. [Medline]. Available at http://dermatology.cdlib.org/1610/4_unknowns/11.

  12. Ghaninezhad H, Ehsani AH, Mansoori P, Taheri A. Naevus comedonicus of the scalp. J Eur Acad Dermatol Venereol. Feb 2006;20(2):184-5. [Medline].

  13. Guldbakke KK, Khachemoune A, Deng A, Sina B. Naevus comedonicus: a spectrum of body involvement. Clin Exp Dermatol. Sep 2007;32(5):488-92. [Medline].

  14. Lefkowitz A, Schwartz RA, Lambert WC. Nevus comedonicus. Dermatology. 1999;199(3):204-7. [Medline].

  15. Nabai H, Mehregan AH. Nevus comedonicus. A review of the literature and report of twelve cases. Acta Derm Venereol. 1973;53(1):71-4. [Medline].

  16. Wood MG, Thew MA. Nevus comedonicus. A case with palmar involvement and review of the literature. Arch Dermatol. Aug 1968;98(2):111-6. [Medline].

  17. Abdel-Aal H, Abdel-Aziz AM. Nevus comedonicus. Report of three cases localized on glans penis. Acta Derm Venereol. 1975;55(1):78-80. [Medline].

  18. Beck MH, Dave VK. Extensive nevus comedonicus. Arch Dermatol. Sep 1980;116(9):1048-50. [Medline].

  19. Paige TN, Mendelson CG. Bilateral nevus comedonicus. Arch Dermatol. Aug 1967;96(2):172-5. [Medline].

  20. Schecter AK, Lester B, Pan TD, Robinson-Bostom L. Linear nevus comedonicus with epidermolytic hyperkeratosis. J Cutan Pathol. Aug 2004;31(7):502-5. [Medline].

  21. Sharma RP, Singh SP. Extensive unilateral nevus comedonicus with bilateral involvement of face. Indian J Dermatol Venereol Leprol. Jul-Aug 2001;67(4):195-6. [Medline].

  22. Woods KA, Larcher VF, Harper JI. Extensive naevus comedonicus in a child with Alagille syndrome. Clin Exp Dermatol. Mar 1994;19(2):163-4. [Medline].

  23. Bhagwat PV, Tophakhane RS, Rathod RM, Tonita NM, Naidu V. Nevus comedonicus along Blaschko's lines. Indian J Dermatol Venereol Leprol. May-Jun 2009;75(3):330. [Medline].

  24. Pavithra S, Pai H, Mallya H, Pai GS. Nevus comedonicus syndrome. Indian J Dermatol. Nov 2011;56(6):771-2. [Medline]. [Full Text].

  25. Kaliyadan F, Nampoothiri S, Sunitha V, Kuruvilla VE. Nevus comedonicus syndrome--nevus comedonicus associated with ipsilateral polysyndactyly and bilateral oligodontia. Pediatr Dermatol. Jul-Aug 2010;27(4):377-9. [Medline].

  26. Decherd JW, Mills O, Leyden JJ. Naevus comedonicus--treatment with retinoic acid. Br J Dermatol. May 1972;86(5):528-9. [Medline].

  27. Milton GP, DiGiovanna JJ, Peck GL. Treatment of nevus comedonicus with ammonium lactate lotion. J Am Acad Dermatol. Feb 1989;20(2 Pt 2):324-8. [Medline].

  28. Caers SJ, Van der Geer S, Beverdam EG, Krekels GA, Ostertag JU. Successful treatment of nevus comedonicus with the use of the Erbium Yag laser. J Eur Acad Dermatol Venereol. Mar 2008;22(3):375-7. [Medline].

  29. Sardana K, Garg V. Successful treatment of nevus comedonicus with ultrapulse CO2 laser. Indian J Dermatol Venereol Leprol: 2009; 75(5):534-5. [Medline].

  30. Deliduka SB, Kwong PC. Treatment of Nevus comedonicus with topical tazarotene and calcipotriene. J Drugs Dermatol. Nov-Dec 2004;3(6):674-6. [Medline].

  31. Peck GL, Yoder FW. Treatment of lamellar ichthyosis and other keratinising dermatoses with an oral synthetic retinoid. Lancet. Nov 27 1976;2(7996):1172-4. [Medline].

  32. Cho SB, Oh SH, Lee JH, Bang D, Bang D. Ultrastructural features of nevus comedonicus. Int J Dermatol. May 2012;51(5):626-8. [Medline].

  33. Sinha A, Natarajan S. Linear morhpea, nevus comedonicus, and lichen striatus in a 5-year-old girl. Pediatr Dermatol. Jan-Feb 2011;28(1):72-4. [Medline].

  34. Vano-Galvan S, Hernández-Martín A, Colmenero I, Torrelo A. Disseminated congenital comedones. Pediatr Dermatol. Jan-Feb 2011;28(1):58-9. [Medline].

 
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