Inflammatory linear verrucous epidermal nevus in groin and labia with claudication: Successfully treated with photodynamic therapy

SIGNIFICANCE

Inflammatory linear verrucous epidermal nevus (ILVEN) is an uncommon type of epidermal nevus and is refractory to therapy. We report the effectiveness of photodynamic therapy (PDT) for treating ILVEN with claudication in a young girl.

ADDITIONAL CONTRIBUTIONS

We thank the patient for granting permission to publish this information.

APPROACH

Aminolaevulinic Acid Hydrochloride (ALA) photodynamic therapy (PDT) was applied six times in 1-month interval.

RESULTS

Most lesions and pruritus have subsided markedly, with mild scarring and a marked reduction in claudication.

CONCLUSIONS

ALA PDT might be an effective and promising treatment for ILVEN in the future.

Widely Spread Unilateral Inflammatory Linear Verrucous Epidermal Nevus (ILVEN)

Inflammatory linear verrucous epidermal nevus (ILVEN) is an epidermal nevus that clinically and histologically mimics linear psoriasis. The pathogenesis of psoriasis has been widely investigated, with recent studies focusing especially on targeting proinflammatory cytokines such as IL-17A, TNFα, IL-23, and IL-12, while little is known about ILVEN. Since the treatment for ILVEN varies widely from the administration of topical ointment for psoriasis to invasive methods such as carbon dioxide gas laser, the differential diagnosis between ILVEN and psoriasis is necessary. In this report, we describe a case of widely spread unilateral ILVEN that clinically and histologically mimicked psoriasis vulgaris and could be diagnosed by immunohistochemical staining focused on the IL-36γ/IL-17A axis.

Successful Treatment of Inflammatory Linear Verrucous Epidermal Nevus with Concomitant Psoriasis Using Etanercept

Linear psoriasis is a rare form of the disease characterized by the linear distribution of lesions involving dermatome or along Blaschko's lines. Clinically, it may resemble inflammatory linear verrucous epidermal nevus; a combination of history, skin examination, and histopathology are required to ensure correct diagnosis and appropriate therapy. This paper describes a case of a 23-year-old male presenting with unilateral erythematous scaly plaques arranged in a linear path on the left leg. Etanercept was initiated after poor response to adalimumab. Improvement of his psoriasis was noted, with PASI 75 reduction after 24 weeks of treatment. Clinical studies have shown excellent efficacy of etanercept, and our patient well tolerated treatment with etanercept for 52 weeks without any adverse effects.