Nevus Comedonicus

This article is an answer to the Case – Congenital Skin Lesion on the Left Clavicular Region

A 19-year-old man presented with a congenital skin lesion on the left clavicular region, with closely arranged, dilated follicular openings with keratinous plugs resembling classic comedones.

These openings were distributed linearly along the left clavicle and extending to the upper back, with a subtle background dyspigmentation that lacked a distinct pattern. There were no associated neurologic or skeletal abnormalities.

Nevus comedonicus, a hamartoma of the pilosebaceous unit, is present at birth or develops in early childhood. It is usually asymptomatic with a predilection for the face, neck, chest, and upper arms, and growth is accelerated during puberty.

The condition may be complicated by inflammation or secondary infection and can be associated with skeletal or central nervous system anomalies and cataracts in the context of the nevus comedonicus syndrome.

Histopathological findings on skin biopsy typically show large, grouped, dilated follicular ostia filled with keratin but devoid of hair shafts.

Treatment options include topical therapy, laser treatment, and surgery. This patient declined further intervention and continues to be monitored in the clinic.