Medical Care

Asymptomatic lesions may be left untreated or therapy may be implemented for cosmetic concerns. Some lesions improve with topical retinoic acid,^[36]salicylic acid, or ammonium lactate lotion.^[37]

Surgical Care

As nevus comedonicus is an asymptomatic benign condition, no treatment is required. Surgical excision of small lesions can be curative and should be considered in consultation with a dermatologic/plastic surgeon. Incomplete excision may result in recurrence of the lesion.^{[38, 39]}

Laser surgery has been tried. Carbon dioxide laser has been used as an ablative technique in eradicating extensive nevus comedonicus; however, this can cause significant scarring and may require grafts if the treatment area is large.^[40]

Treatment using a 1450-nm diode laser in conjunction with a topical retinoid has been documented to show improvement in the lesion.^[41]In 2019, a case report described improvement of late-onset symptoms with an erbium:YAG laser and, more recently, with a microneedling fractional radiofrequency device.^{[42, 43]}

Consultations

If defects associated with a nevus comedonicus syndrome are found, consult the appropriate specialist, as follows:

Neurologist for seizure disorders
Ophthalmologist for cataracts
Orthopedist for skeletal deformities

Medication

Kofmann S. A case of rare localization and spreading of comedones. Arch Dermatol Syphilol. 1895. 32:177-8.
Patrizi A, Neri I, Fiorentini C, Marzaduri S. Nevus comedonicus syndrome: a new pediatric case. Pediatr Dermatol. 1998 Jul-Aug. 15(4):304-6. [QxMD MEDLINE Link].
Engber PB. The nevus comedonicus syndrome: a case report with emphasis on associated internal manifestations. Int J Dermatol. 1978 Nov. 17(9):745-9. [QxMD MEDLINE Link].
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. 2006 Nov-Dec. 16(6):697-8. [QxMD MEDLINE Link].
Giam YC, Ong BH, Rajan VS. Naevus comedonicus in homozygous twins. Dermatologica. 1981. 162(4):249-53. [QxMD MEDLINE Link].
Levinsohn JL, Sugarman JL, Yale Center for Mendelian Genomics, McNiff JM, Antaya RJ, Choate KA. Somatic Mutations in NEK9 Cause Nevus Comedonicus. Am J Hum Genet. 2016 May 5. 98 (5):1030-7. [QxMD MEDLINE Link].
Liu F, Yang Y, Zheng Y, Liang YH, Zeng K. Mutation and expression of ABCA12 in keratosis pilaris and nevus comedonicus. Mol Med Rep. 2018 Sep. 18 (3):3153-3158. [QxMD MEDLINE Link].
Grimalt R, Caputo R. Posttraumatic nevus comedonicus. J Am Acad Dermatol. 1993 Feb. 28(2 Pt 1):273-4. [QxMD MEDLINE Link].
Vasiloudes PE, Morelli JG, Weston WL. Inflammatory nevus comedonicus in children. J Am Acad Dermatol. 1998 May. 38(5 Pt 2):834-6. [QxMD MEDLINE Link].
Kirtak N, Inaloz HS, Karakok M, Erguven HG, Ozgoztasi O. Extensive inflammatory nevus comedonicus involving half of the body. Int J Dermatol. 2004 Jun. 43(6):434-6. [QxMD MEDLINE Link].
Asokan N, Sridevi PK. Inflammatory nevus comedonicus in an infant. Nov-Dec/2008.
Bettoli V, Toni G, Ricci M, Zauli S, Virgili A. Hidradenitis suppurativa-acne inversa-like lesions complicating naevus comedonicus: second case supporting the mechanical stress as a triggering factor. G Ital Dermatol Venereol. 2016 Jun. 151 (3):306-7. [QxMD MEDLINE Link].
Qian G, Liu T, Zhou C, Zhang Y. Naevus comedonicus syndrome complicated by hidradenitis suppurativa-like lesions responding to acitretin treatment. Acta Derm Venereol. 2015 Nov. 95 (8):992-3. [QxMD MEDLINE Link].
Mathachan SR, Arora P, Ahuja A, Gautam RK. Late onset nevus comedonicus of scalp: a rare site for an uncommon condition. Dermatol Online J. 2019 Mar 15. 25 (3):[QxMD MEDLINE Link].
Zanniello R, Pilloni L, Conti B, Faa G, Rongioletti F. Late-Onset Nevus Comedonicus With Follicular Epidermolytic Hyperkeratosis-Case Report and Review of the Literature. Am J Dermatopathol. 2019 Jun. 41 (6):453-455. [QxMD MEDLINE Link].
Sikorski D, Parker J, Shwayder T. A boy with an unusual scalp birthmark. Nevus Comedonicus. Int J Dermatol. 2011 Jun. 50(6):670-2. [QxMD MEDLINE Link].
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. 16:11. [QxMD MEDLINE Link]. [Full Text].
Vora RV, Kota RS, Sheth NK. Dermoscopy of Nevus Comedonicus. Indian Dermatol Online J. 2017 Sep-Oct. 8 (5):388-389. [QxMD MEDLINE Link].
Ghaninezhad H, Ehsani AH, Mansoori P, Taheri A. Naevus comedonicus of the scalp. J Eur Acad Dermatol Venereol. 2006 Feb. 20(2):184-5. [QxMD MEDLINE Link].
Guldbakke KK, Khachemoune A, Deng A, Sina B. Naevus comedonicus: a spectrum of body involvement. Clin Exp Dermatol. 2007 Sep. 32(5):488-92. [QxMD MEDLINE Link].
Lefkowitz A, Schwartz RA, Lambert WC. Nevus comedonicus. Dermatology. 1999. 199(3):204-7. [QxMD MEDLINE Link].
Nabai H, Mehregan AH. Nevus comedonicus. A review of the literature and report of twelve cases. Acta Derm Venereol. 1973. 53(1):71-4. [QxMD MEDLINE Link].
Wood MG, Thew MA. Nevus comedonicus. A case with palmar involvement and review of the literature. Arch Dermatol. 1968 Aug. 98(2):111-6. [QxMD MEDLINE Link].
Kaliyadan F, Nambiar A, Al Ameer A, Amri M. Nevus comedonicus of the scalp. Skinmed. 2014 Jan-Feb. 12(1):59-60. [QxMD MEDLINE Link].
Kikkeri NN, Priyanka R, Parshawanath H. Nevus comedonicus on scalp: a rare site. Indian J Dermatol. 2015 Jan-Feb. 60 (1):105. [QxMD MEDLINE Link].
Abdel-Aal H, Abdel-Aziz AM. Nevus comedonicus. Report of three cases localized on glans penis. Acta Derm Venereol. 1975. 55(1):78-80. [QxMD MEDLINE Link].
Dufour DN, Bryld LE, Jemec GB. Hidradenitis suppurativa complicating naevus comedonicus: the possible influence of mechanical stress on the development of hidradenitis suppurativa. Dermatology. 2010. 220 (4):323-5. [QxMD MEDLINE Link].
Beck MH, Dave VK. Extensive nevus comedonicus. Arch Dermatol. 1980 Sep. 116(9):1048-50. [QxMD MEDLINE Link].
Paige TN, Mendelson CG. Bilateral nevus comedonicus. Arch Dermatol. 1967 Aug. 96(2):172-5. [QxMD MEDLINE Link].
Schecter AK, Lester B, Pan TD, Robinson-Bostom L. Linear nevus comedonicus with epidermolytic hyperkeratosis. J Cutan Pathol. 2004 Aug. 31(7):502-5. [QxMD MEDLINE Link].
Sharma RP, Singh SP. Extensive unilateral nevus comedonicus with bilateral involvement of face. Indian J Dermatol Venereol Leprol. 2001 Jul-Aug. 67(4):195-6. [QxMD MEDLINE Link].
Woods KA, Larcher VF, Harper JI. Extensive naevus comedonicus in a child with Alagille syndrome. Clin Exp Dermatol. 1994 Mar. 19(2):163-4. [QxMD MEDLINE Link].
Bhagwat PV, Tophakhane RS, Rathod RM, Tonita NM, Naidu V. Nevus comedonicus along Blaschko's lines. Indian J Dermatol Venereol Leprol. 2009 May-Jun. 75(3):330. [QxMD MEDLINE Link].
Pavithra S, Pai H, Mallya H, Pai GS. Nevus comedonicus syndrome. Indian J Dermatol. 2011 Nov. 56(6):771-2. [QxMD MEDLINE Link]. [Full Text].
Kaliyadan F, Nampoothiri S, Sunitha V, Kuruvilla VE. Nevus comedonicus syndrome--nevus comedonicus associated with ipsilateral polysyndactyly and bilateral oligodontia. Pediatr Dermatol. 2010 Jul-Aug. 27(4):377-9. [QxMD MEDLINE Link].
Decherd JW, Mills O, Leyden JJ. Naevus comedonicus--treatment with retinoic acid. Br J Dermatol. 1972 May. 86(5):528-9. [QxMD MEDLINE Link].
Milton GP, DiGiovanna JJ, Peck GL. Treatment of nevus comedonicus with ammonium lactate lotion. J Am Acad Dermatol. 1989 Feb. 20(2 Pt 2):324-8. [QxMD MEDLINE Link].
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. 2008 Mar. 22(3):375-7. [QxMD MEDLINE Link].
Sardana K, Garg V. Successful treatment of nevus comedonicus with ultrapulse CO2 laser. 2009; 75(5):534-5.
Manikavachakan N, Siddaraju MN, Rajendran SC, Venkataraman A. Extensive Nevus Comedonicus, Complicated with Recurrent Abscesses, Successfully Treated with Surgical Resurfacing. J Cutan Aesthet Surg. 2018 Jan-Mar. 11 (1):33-37. [QxMD MEDLINE Link].
Wen X, Li Y, Hamblin MR. A Microneedling Fractional Radiofrequency Device for the Treatment of Nevus Comedonicus. Dermatol Surg. 2019 Feb 14. [QxMD MEDLINE Link].
Aktaş Karabay E, Yapıcıer Ö. Successful treatment of late-onset nevus comedonicus with Er:YAG laser. J Cosmet Dermatol. 2019 Jul 22. [QxMD MEDLINE Link].
Wen X, Li Y, Hamblin MR. A Microneedling Fractional Radiofrequency Device for the Treatment of Nevus Comedonicus. Dermatol Surg. 2020 Jan. 46 (1):148-150. [QxMD MEDLINE Link].
Sahu P, Aggarwal P, Dayal S, Kumar Jain V. Biologic therapy: a boon for hidradenitis suppurativa-like lesions complicating naevus comedonicus in a prepubertal child. Clin Exp Dermatol. 2019 Apr. 44 (3):322-324. [QxMD MEDLINE Link].

Media Gallery

Nevus comedonicus. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/assets/Uploads/lesions/com-naev1.jpg).

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Author

Marjon Vatanchi, MD Board Certified Dermatologist, Board Certified Micrographic Dermatologic Surgeon

Marjon Vatanchi, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, Dermatologic Society of Greater New York, Medical Dermatology Society, National Psoriasis Foundation, New England Dermatological Society, Society for Pediatric Dermatology, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Ally-Khan B Somani, MD, PhD Assistant Professor of Dermatology, Director of Dermatologic Surgery and Cutaneous Oncology Division, Director of Micrographic Surgery and Dermatologic Oncology (MSDO) Fellowship, Department of Dermatology, Adjunct Assistant Professor of Otolaryngology-Head and Neck Surgery, Indiana University Health, Indiana University School of Medicine

Ally-Khan B Somani, MD, PhD is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, Association for the Advancement of Wound Care, Association of Professors of Dermatology, Dermatologic and Aesthetic Surgery International League, European Academy of Dermatology and Venereology, European Society for Micrographic Surgery, International Society for Dermatologic Surgery, International Society of Dermatology, International Transplant and Skin Cancer Collaborative, Society for Investigative Dermatology, Skin Cancer Foundation

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

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: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

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.

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.

Acknowledgements

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.

Nevus Comedonicus Treatment & Management

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