Verrucous nevus is a pigmented formation, which is a warty growth towering over the skin. Verrucose nevus has a bumpy surface consisting of individual lobules (looks like cauliflower); dark color. Unlike melanoma-threatening nevi, it is characterized by slow growth, is not prone to ulceration and bleeding. To differentiate verrucous nevus from other skin neoplasms allows dermatoscopy, biopsy and histological examination. Removal of verrucous nevus can be performed surgically, by radio wave method, by electrocoagulation, laser coagulation, cryodestruction.
Verrucous nevus (warty, keratotic, ichthyosiform) is a benign formation consisting of papillomatous-warty growths. It can be pigmented to varying degrees or have a flesh color. Such nevi are located in different parts of the body or on the face, but most often on the skin of the extremities. Verrucous nevus is congenital or occurs in early childhood. In dermatology, it is classified as melanomoneurophic nevi of the papillomatous type. It can have a localized (limited) form in the form of a single formation with clear boundaries or a systemic form – in the form of a stretching garland.
The localized form of verrucous nevus is a neoplasm protruding above the skin up to 1 cm in size, less often 2-4 cm. It consists of papillomatous outgrowths of the skin, tightly adjacent to each other. The rough and bumpy surface of the nevus makes it look like a wart. There may be several such formations in different parts of the body. In childhood, there is a slight growth and an increase in the number of nevi. Moreover, the growth of the nevus is noted more in height than in diameter. In adulthood, growth does not occur, and in adolescents, only those nevi that have apocrine and sweat glands in their composition increase.
The systemic form of verrucous nevus is more often located on the trunk along the vessels and nerves and may have a large area. The location of the nevus within one half of the body is characteristic. The systemic nevus consists of many keratinized papillomatous formations, individual clusters of which can be separated by a small area of unchanged skin. Formations of such a nevus usually have a brown color. Being arranged linearly, they resemble garlands in their appearance.
Diagnosis is based on a visual study of education and anamnesis data indicating its appearance in childhood and the absence of overgrowth. To confirm the diagnosis, a biopsy and histological examination are performed, which reveals the unevenness of the granular layer of the epidermis, the presence of hyperkeratosis, papillomatosis and acanthosis. Verrucous nevus is differentiated from acne nevus, common wart, lichen planus.
Surgical excision of the verrucous nevus is used for large sizes of the formation and in situations where its thorough histological examination is necessary. Radio wave removal of the nevus is less traumatic. But with a large amount of education, stitches have to be applied to the wound remaining after its removal.
Layered laser removal of nevus gives a good cosmetic effect, is an absolutely sterile and bloodless method. However, it does not allow histological examination of the removed material, since tissue evaporation occurs during the removal process. The removal of localized forms can be carried out by electrocoagulation.
In the treatment of systemic verrucous nevi, which occupy a significant area, ointments with vitamins E and A, compresses with salicylic vaseline are used. Cryodestruction of formations is possible, but repeated procedures are required. Removal of nevi is usually not carried out in children under 2 years of age.
The prognosis is favorable. Verrucous nevus usually does not grow and does not transform into melanoma of the skin. However, the situation may change with permanent injury to the nevus. Chronic injury can give an impetus to the growth of the nevus and cause its infection.