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Verrucous epidermal nevus (VEN) is a benign, noninflammatory malformation usually present at birth or occurring within the first years of life. It is composed of keratinocytes that arise from pluripotential germ cells in the basal layer of the embryonic ectoderm and results from mosaic postzygotic mutations. VEN clinically appears as skin-colored to brown, sharply demarcated, papillomatous papules coalescing into plaques. The diagnosis is usually based on clinical presentation and, in selected cases, on histopathology examination that reveals epidermal hyperplasia, papillomatosis with elongation of rete ridges, and pigmented keratinocytes surrounding the dermal papillae. Dermoscopy and reflectance confocal microscopy (RCM) are valuable, noninvasive techniques that support the diagnosis in clinical practice in several fields of dermatology including cutaneous tumors as well as inflammatory and infectious dermatoses [1]. Dermoscopy has shown in 8 cases of VEN the characteristic presence of large brown circles, consisting of hyperchromic brown edge surrounding a hypochromic area.  The aim of this study was to evaluate and correlate dermoscopy (Dermlite; 3Gen, San Juan Capistrano, CA, USA), RCM (VivaScope3000; Caliber I.D., Rochester, NY, USA) and histopathological findings in a series of 9 patients with a clinical and/or histopathologically proven diagnosis of VEN. In all cases VEN had been present since early infancy. All participants provided informed consent.

Verrucous Epidermal Nevus: Dermatoscopy, Reflectance Confocal Microscopy and Histopathological Correlation