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.

Procedures

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.

Treatment & Management

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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 Workup

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

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