Verrucous epidermal nevi: some aspects of pathogenesis and clinical cases

Verrucous epidermal nevi ― hamartomas of keratinocyte or epidermal appendages, located on the skin or mucous membranes in the form of isolated birthmarks, less often have a linear localization. The pathogenesis of verrucous epidermal nevi has not been fully defined, probably the development of the disease is associated with genetic mutations during embryogenesis and represent a special form of skin mosaicism. Verrucous epidermal nevi are skin pathologies that require attention as potentially dangerous in terms of the development of malignant neoplasms of the skin and due to the possible difficulties in their diagnosis and differential diagnosis.

Analysis of current data on the pathogenesis and differential diagnosis of various forms of verrucous epidermal nevi, presentation of clinical cases of verrucous epidermal nevi.

The article considers two clinical cases of linear verrucous epidermal nevus. Studies of the pathogenesis of WEN have shown the presence of changes in expressed proteins by affected skin cells, such as OGN, NT5C3A, ADD1, OLFML1, DHRS1, CALML5, SAMHD1, SFRP2, SPRR1B and SERPINB13. This may indicate the participation in the development of verrucous epidermal nevi of changes in the p53 signaling pathway, the cellular response to a cytokine stimulus, and disturbances in cell adhesion and differentiation of Th1 and Th2 cells. The presented clinical cases describe linear verrucous epidermal nevus in order to study the diagnosis of the disease, based on the clinical picture. The need for differential diagnosis of various forms of verrucous epidermal nevi is due to their clinical and sometimes histological similarity with other skin formations. Immunohistochemical examination, genetic analysis using sequencing of the affected skin exome, and proteomic analysis of proteins expressed by affected skin cells help to carry out differential diagnosis.

The study of the mechanisms of development of this disease will help not only in differential diagnosis with other skin diseases, but will also allow finding new approaches to its conservative therapy.