Pathology of Epidermal
Nevus and Inflammatory
Epidermal Nevus (ILVEN)
"Developmental malformations of the epidermis"
Dr Sampurna Roy MD May 2016
Epidermal nevus is a developmental malformation of the epidermis.
These lesions are commonly located on the neck, trunk or extremities.
Macroscopically epidermal nevi present as warty brown plaque, scaly discolouration or linear lesions.
Microscopically different patterns are noted:
The common variant displays laminated hyperkeratosis, papillomatosis and acanthosis.
There is thickening of the granular layer and mild increase in basal melanin pigment.
Some of the rare histologic patterns resemble seborrheic keratosis , acrokeratosis verruciformis or epidermolytic hyperkeratosis.
Inflammatory Linear Verrucous Epidermal Nevus: (ILVEN)
Inflammatory Linear Verrucous Epidermal Nevus, also known as ILVEN, is clinicopathological subgroup of epidermal nevus.
It resembles linear psoriasis both clinically and histologically.
The lesion presents as persistent linear, pruritic eruptions.
It is composed of erythematous, slightly verrucous scaling papules arranged in one or several lines on the lower extremities.
The usual time of onset is early childhood. The disease may occur in adults.
The histologic feature is usually that of a non-specific chronic dermatitis.
There is psoriasiform epidermal hyperplasia and overlying alternate parakeratosis and orthokeratotic areas of hyperkeratosis.
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