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Epidermal Naevus — SCE Dermatology MCQ

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ModeratePaediatric DermatologyEpidermal NaevusSCE Dermatology

A 12-year-old girl presents with a 2 cm verrucous plaque following Blaschko lines on her left arm. It has been present since early childhood and has not changed significantly. Biopsy shows papillomatosis, acanthosis, and hyperkeratosis. What is the most likely diagnosis?

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Correct answer: D — Epidermal naevus (verrucous type)

Verrucous epidermal naevus is a hamartomatous lesion following Blaschko lines (lines of embryonic cell migration), typically present from birth or early childhood. Histology shows papillomatosis, acanthosis, and hyperkeratosis. It is usually stable and non-inflammatory. ILVEN is a pruritic inflammatory variant that can mimic linear psoriasis histologically. Lichen striatus is an acquired self-limiting linear eruption in children. Extensive epidermal naevi may be associated with systemic abnormalities (epidermal naevus syndrome) requiring neurological and skeletal screening.

Reference: BAD 2019 Patient Information; Paediatric Dermatology Textbook