Full-thickness surgical excision for the treatment of inflammatory linear verrucous epidermal nevus

Inflammatory linear verrucous epidermal nevus (ILVEN) is a benign cutaneous hamartoma characterized by intensely erythematous, pruritic, inflammatory papules that occur as linear bands along the lines of Blaschko. Because of its chronic and unremitting symptomatology, patients with ILVEN seek medica l treatment for relief of discomfort as well as concerns regarding cosmetic appearance. Reported therapeutic approaches include topical agents, dermab rasion, cryotherapy, laser therapy, and partial-thickness excision. Unfortu nately, no one therapy has been successful consistently. Medical management is often um. satisfactory, because improvement tends to be temporary. Surg ical modalities have met with better success in relief of symptoms but at t he risk of marked scarring and a high rate of recurrence. Furthermore, the occurrence of extensive ILVEN or localization to certain anatomic regions h as been considered previously a relative contraindication to excision. The authors report 4 patients with extensive ILVEN treated successfully with fu ll-thickness surgical excision. Our report underscores the effectiveness of this surgical modality for the definitive treatment of ILVEN.