what to do

My 5 year old son has developed a rash on his arm that is starting to spread.It is now on his shoulder and on his wrist.I took him to the dermatologist and was told it was inflammatory linear verrucous epidermal nevus.Now this diagnosis was done on a visual level without any other tests,so I,m not 100% sure that it is so.I,m currently applying some Ammonium Lactate Cream but I,m not sure it is helping any.Is there something else on the market that can arrest this spreading.I want to get a handle on it before it spreads any further.I would appreciate any additional info on this and what I might try to help get this under control.I was told by the dermatologist that this could last several years before it dissapears.Thank you beforehand for your help.Robert.

[Jasmina Jankicevic, MD, MSc, CCRP]

Welcome to the Dermatology Expert Forum, Robert!

Let us start with your concern about accuracy of diagnosis of ILVEN. Histopathological result (skin biopsy) will be important piece of the puzzle. Dermatologist will correlate it with clinical findings before final diagnosis is established. In addition, it is important to recognize a variant of epidermal nevus because course (development) of disorder is clinically different.

Among differential diagnoses, Lichen striatus, self-limited, benign linear dermatosis that predominantly affects children, may be difficult to distinguish from ILVEN.

In regards to therapy, most reliable treatment of epidermal nevus is excision, but not advisable if that epidermal nevus is very extensive or located at certain, surgically challenging sites. Topical treatments are based on application of different keratolytics (peeling agents such as retinoic acid, ammonium lactate, alpha-hydroxy acids, trichloracetic acid, etc.) or use of dermabrasion, cryotherapy, laser therapy, electrofulguration. However, recurrence is common because these treatment modalities usually remove only the superficial portion of the epidermal nevus.

Wishing You Optimal Health,
Dr. Jasmina Jankicevic

[lmcadam]

A related discussion, Can it be explained to me in simple terms? was started.

[jcarrie]

I have epidermal nevus inbetween my breasts. Its a line that goes down right inbetween them its a brown discolored area and also have a brown spot above the line inbetween my breasts. Someone please help me on what I can do to get it done!!!!