The patient is a four year-old boy who was referred for
evaluation of a slightly rough patch on his right cheek that has been present
for over a year. He is otherwise well.
O/E: There is a
subtle 1.5 cm in diameter erythematous patch on his right cheek. Dermatoscopy revealed a group of sharply
demarcated plugs that appear to be comedones.
Clinically, this was not as evident.
Clinical and Dermatological Images:
Diagnosis: Small subtle
nevus comedonicus.
Discussion: I feel
this is probably a nevus comedonicus.
I’ve only seen a few of these and all were obvious: not so with this
case. Not much is known about the
evolution of these lesions. Topical
retinoids are of some value; but since this doesn’t bother the patient I am
reluctant to have his mother rub a topical agent on the area for two to three
months. Does anyone feel that tazarotene
is preferable to tretinoin in similar cases?
Comedone extraction would be easy, but can be traumatizing in a young
child. Once I hear other ideas I will
discuss options with his parents.
References:
1. Dermoscopy on nevus comedonicus: a case report and review
of the literature. Kamińska-Winciorek
G1, Spiewak R.
Postepy Dermatol Alergol. 2013 Aug;30(4):252-4. Free Full Text.
2. Nevus comedonicus: an updated review. Tchernev G, et. al.
Dermatol Ther (Heidelb). 2013 May 25;3(1):33-40. Full Free Text.
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