Nevus Comedonicus Workup

Updated: Jan 27, 2020
  • Author: Marjon Vatanchi, MD; Chief Editor: William D James, MD  more...
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Workup

Laboratory Studies

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

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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.

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Procedures

Skin biopsy may be performed to confirm the diagnosis.

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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.

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