Pediatric linear epidermal nevus

What is a pediatric linear epidermal nevus?

This is a type of birthmark that is usually present at birth, but may develop later in childhood. They are usually light or dark brown in color.

They may start as a flat area in the shape of a line or as a “skin tag.” Over time, they grow and become thicker like a wart. They can be located anywhere on the body.

Rare epidermal nevi have a specific feature called epidermolytic hyperkeratosis (EHK). This feature can only be seen under the microscope (not by looking at the skin).

People with the EHK type of birthmark may pass a genetic skin condition call EHK or bullous (blistering) ichthyosis on to their children. EHK consists of blistering at birth, then scaling of the entire body later in life. To see if you are at risk to pass on EHK to your future children, you may wish to have a skin biopsy done on your birthmark to see if it is the EHK type before deciding to start a family.

What are the different types of pediatric linear epidermal nevus?

Pediatric inflammatory linear verrucous epidermal nevus (ILVEN) - This is a type of epidermal nevus which is more red and scaly. These lesions tend to be very itchy. Treatment of the itching consists of steroid creams or antihistamines (like Benadryl®), but often these only help a little. The only treatment available to remove these lesions is surgery.

How is a pediatric linear epidermal nevus treated?

Several over-the-counter medications, including topical medications (creams), can help improve the color and thickness of the lesions. Options are mild alpha-hydroxy lotions such as over the counter Lac-Hydrin® 5%, Am Lactin® 12%, Aqua Glycolic or Eucerin Plus® or bland lubricants such as Aquaphor® or Vaseline®.

Prescription medication that may help include Dovonex®, Retin-A®, or Efudix®. The only way to completely remove these lesions is to have them removed by surgery. Laser does not permanently remove epidermal nevi.