Child presents with linear verrucous plaques on the trunk with vacuolisation of keratinocytes in S.Spinosum and S.Granulosum. Diagnosis is?
Ans. is 'c' i.e., Verrucuous epidermal nevus Linear verrucous lesions, with characteristic histopathological feature of granular degeneration of the epidermis favours the diagnosis of verrucous epidermal nevus.Epidermal nevusEpidermal nevi are hamartomas that are characterized by hyperplasia of the epidermis and adnexal structures.These nevi may be classified into a number of distinct variants which are based on clinical morphology, extent of involvement and the predominant epidermal structure in the lesion.Variants of the epidermal nevi are -Verrucous epidermal nevusNevus sebaceousNevus comedonicusEccrine nevusApocrine nevusBecker's nevusWhite sponge nevusVerrucous epidermal nevusVerrucous epidermal nevus consists of hyperplasia of the surface epidermis and typically appears as verrucous papules that coalesce to form well demarcated, skin colored to brown, papillomatous plaque.Most lesions are present at birth and develop during infancy. They enlarge slowly during childhood and generally reach a stable size at adolescence.Lesions may be localized or diffuse.Linear configurations are common especially on the limbs and may follow skin tension lines or Blaschko's lines.The salient histological features are -Perinuclear vacuolization of the cells in the stratum spinosum and stratum granulosumIrregular cellular boundaries peripheral to the vacuolization and increased number of irregularly shaped large keratohyaline granules.Compact hyperkeratosis in stratum corneumDarrier white diseaseAutosomal dominant disease.Males and females are equally affected.Darrier white disease is not present at birth and usually begins in the first or second decade.Characteristic sites of predilection are the face, forehead, scalp, chest and the back (seborrheic sites).Clinical features consists of warty papules and plaques in (seborrheic sites).Histology shows supra basal acantholysis in epidermis with dyskeratotic cells.Incontinentia pigmentiX linked disease (so only seen in females)Lesions are present along the Blaschko lines, which are initially vesicular, that later on turns into verrucous lesions and hyperpigmented stages.Common histological features are :HyperkeratosisEosinophilic spongiosis of epidermisBasal cell degenerationPigment incontinent
Incontinenta pigmenti
Delayed hypersensitivity reaction
Verrucous epidermal nevus
Linear darriers disease
Other Papulosquamous Disorders