Ranugha P S S, Betkerur Jayadev B, Veeranna S, Basavaraj Vijaya
Department of Dermatology and STD, JSS Medical College and Hospital, JSS University, Mysuru, Karnataka, India.
Department of Pathology, JSS Medical College and Hospital, JSS University, Mysuru, Karnataka, India.
Indian Dermatol Online J. 2018 Sep-Oct;9(5):334-337. doi: 10.4103/idoj.IDOJ_337_17.
Locus minoris resistentiae (LMR) is a site of the body that offers lesser resistance than the rest of the body to the onset of disease. It can be congenital or acquired. Areas of cutaneous mosaicism such as epidermal nevi can act as congenital LMR, leading to the development of inflammatory skin conditions or skin tumors on these. The occurrence of an infectious condition such as warts over nevi is rare. We report three cases of verrucous epidermal nevi (VENs) with the development of verrruca overlying the nevus later in life. The three patients had VEN on forehead, preauricular, and presternal area, respectively, since birth, with development of a warty lesion overlying these a few months before presenting to us. Skin biopsy and histopathological examination of the linear verrucous lesion were suggestive of VEN with hyperkeratosis, thickened epidermis, and papillomatosis. There was no evidence of epidermolytic hyperkeratosis or increased sebaceous glands in the dermis. Biopsy of the new warty lesion showed findings of verruca in all the patients. With the above findings, a diagnosis of verruca superimposed on linear VEN was made in all the three cases. The warts were removed by electrofulguration. Several acquired skin disorders, including inflammatory dermatoses, adnexal disorders, and neoplasms, have been shown to occur superimposed on epidermal or sebaceous nevus. Ours is probably the first ever description of a wart occurring on VEN.
抵抗力较弱部位（LMR）是身体中对疾病发生的抵抗力低于身体其他部位的部位。它可以是先天性的或后天获得的。皮肤镶嵌区域，如表皮痣，可作为先天性LMR，导致这些部位发生炎症性皮肤病或皮肤肿瘤。痣上出现传染性疾病如疣的情况很少见。我们报告了3例疣状表皮痣（VENs）病例，这些病例在生命后期痣上出现了疣。这3例患者自出生以来分别在前额、耳前和胸骨前区域患有VEN，在前来就诊前几个月，这些部位出现了疣状病变。对线性疣状病变进行皮肤活检和组织病理学检查提示为伴有角化过度、表皮增厚和乳头瘤病的VEN。真皮中没有表皮松解性角化过度或皮脂腺增多的证据。对新的疣状病变进行活检显示所有患者均有疣的表现。根据上述发现，所有3例均诊断为叠加在直线型VEN上的疣。通过电灼术去除了疣。几种后天性皮肤疾病，包括炎症性皮肤病、附属器疾病和肿瘤，已被证明可叠加在表皮痣或皮脂腺痣上。我们的病例可能是首次描述发生在VEN上的疣。
