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March 2006

Successful Treatment of a Widespread Inflammatory Verrucous Epidermal Nevus With Etanercept

Arch Dermatol. 2006;142(3):393-403. doi:10.1001/archderm.142.3.401

Inflammatory linear verrucous epidermal nevus (ILVEN) is an uncommon dermatosis characterized by erythematous, pruritic, inflammatory papules that occur as linear bands along the lines of Blaschko. Histologic analysis reveals epidermal psoriasiform hyperplasia with characteristic alternating orthokeratosis and parakeratosis. Lesions may be difficult to distinguish from linear psoriasis because of their clinical and histopathologic similarities.1 Unlike psoriasis, ILVEN is typically refractory to treatment, and patients seek medical care for relief of pruritus as well as cosmetic improvement. Reported treatments include topical agents, dermabrasion, cryotherapy, laser therapy, and surgical excision. These therapies have a high failure rate because of incomplete relief of symptoms, scarring, or recurrence.2