brand logo

Am Fam Physician. 2023;108(3):301-302

Author disclosure: No relevant financial relationships.

A female infant born at 39 1/7 weeks of gestation via uncomplicated spontaneous vaginal delivery was evaluated in the delivery room. Her Apgar scores were 9/9. Physical examination revealed dry, whitish-gray plaques in a linear pattern from the right inguinal area over the medial thigh and lateral shin, involving the plantar and dorsal surfaces of the right foot (Figure 1 and Figure 2). The remainder of the physical examination was unremarkable. The patient was afebrile with a normal pulse and respiratory rate. Laboratory test results were within normal limits, including routine newborn screenings and complete blood count.

Question

Based on the patient's history and physical examination findings, which one of the following is the most likely diagnosis?

  • A. Congenital herpes simplex.

  • B. Congenital syphilis.

  • C. Inflammatory linear verrucous epidermal nevus.

  • D. Sebaceous nevus.

Discussion

The answer is C: inflammatory linear verrucous epidermal nevus (ILVEN), a variant of an epidermal nevus or mole. It is characterized by recurrent inflammation with a chronic eczematic or psoriasiform component. ILVEN is a benign overgrowth of cells in the epidermis that presents as erythematous, verrucous papules and plaques that characteristically follow the lines of normal embryologic cell migration in the skin (Blaschko lines). The lesions can be red, brown, or the same color as the surrounding skin.1 ILVEN is commonly found on the lower extremities. Children are most often affected, although cases of adult-onset ILVEN have been reported.2

Already a member/subscriber?  Log In

Subscribe

From $165
  • Immediate, unlimited access to all AFP content
  • More than 130 CME credits/year
  • AAFP app access
  • Print delivery available
Subscribe

Issue Access

$59.95
  • Immediate, unlimited access to this issue's content
  • CME credits
  • AAFP app access
  • Print delivery available
Purchase Access:  Learn More

The editors of AFP welcome submissions for Photo Quiz. Guidelines for preparing and submitting a Photo Quiz manuscript can be found in the Authors' Guide at https://www.aafp.org/afp/photoquizinfo. To be considered for publication, submissions must meet these guidelines. Email submissions to afpphoto@aafp.org.

This series is coordinated by John E. Delzell Jr., MD, MSPH, associate medical editor.

A collection of Photo Quiz published in AFP is available at https://www.aafp.org/afp/photoquiz

Continue Reading

More in AFP

More in Pubmed

Copyright © 2023 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.