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Nevus Comedonicus Workup

  • Author: Rossitza Lazova, MD; Chief Editor: William D James, MD  more...
Updated: Jun 27, 2016

Laboratory Studies

Many cases have been reported in which extensive laboratory evaluation has yielded no abnormalities. No particular laboratory test is specifically indicated.


Imaging Studies

Perform imaging studies of obvious bony abnormalities if nevus comedonicus syndrome is suspected. The abnormalities described can be seen on routine radiographs of the area.



Skin biopsy may be performed to confirm the diagnosis.


Histologic Findings

Typically, closely positioned dilated follicular infundibula with prominent orthokeratotic plugging are present, sebaceous elements are rudimentary or absent, and mature hair follicles are absent. The follicular walls are lined by epithelium that often appears atrophic, and it is composed of a few layers of keratinocytes. Epithelial follicular budding may be seen. The interfollicular epidermis is often normal but may appear papillomatous or hyperkeratotic. No apocrine glands are seen. Several reports of nevus comedonicus show epidermolytic hyperkeratosis in the follicular epithelium. On volar surfaces, eccrine ducts are involved.

Contributor Information and Disclosures

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, International Society of Dermatopathology

Disclosure: Nothing to disclose.

Specialty Editor Board

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

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

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, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

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.


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.

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