A line of comedones on the face of a child.
Many consider nevus comedonicus a subtype of the epidermal nevus. The characteristic feature is a dilated follicular opening filled with a keratin plug--resembling a comedone.
There is no gender or racial predilection. Approximately half are apparent at birth and the rest typically are noticed within the first 15 years of life.
Linear or grouped comedones most common on the face but also elsewhere is characteristic. Extensive lesions may follow Blaschko's lines. Abscesses, cysts or scarring may occur within the lesion. The nevus comedonicus may occur on the face, trunk or extremities. NC rarely occurs on the genitalia, palms or scalp. The NC usually occurs in isolation. However--as with epidermal nevi--larger lesions may be associated with various musculoskeletal, CNS and ocular defects.
No therapy is required. Small lesions may be excised. Topical ammonium lactate lotion maybe applied BID to reduce or prevent comedone formation. A topical retinoid may be prescribed as well. Oral isotretinoin usually does not help. Laser has been used with some success.
New onset in 4 year old.
Extensive lentigo simplex, linear epidermolytic, nevus and epidermolytic nevus comedonicus caused by a somatic mutation in KRT10. BJD 2015;173;288
Unilateral Facial. Indian Pediatr 2013;50: 1177
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