What causes epidermal nevus on the back of the shoulder?

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Posted on Fri, 11 Aug 2017 in Skin Hair and Nails
Question: Hello -- this question pertains to my son, who is 19 years old. He had a flat and lightly pigmented lesion on the back of his shoulder which appeared around the time he was approximately 11 or so; over the years and throughout puberty, it has grown a small bit, become a bit more raised and darker, and rougher in texture. I had asked his pediatrician to check it throughout the years, and he was never concerned. Today I took him to a dermatologist for a full skin screening, and specifically to look at that lesion. The physician's assistant checked it with a dermascope and diagnosed it as a "linear epidermal nevus". It is approximately .75 to 1.00 cm in size, and he has no other lesions of the same, only a few freckles and moles. He is in good health with no conditions, neurological, skeletal, or otherwise.

Unfortunately, I made the mistake of googling "linear epidermal nevus" and my search led me to references to rare syndromes associated with it, and also led to information about a genetic mutation that can be passed along to children of those with that type of lesion, causing babies born with ichthyosis (?).

Unfortunately, I do not have an image to provide; however, if we presume that it was a correct diagnosis of a (relatively small) solitary linear epidermal nevus, and he has no other health conditions or issues, do you feel that there is anything for me to be worried about? The physician's assistant at the dermatologist's office was not concerned at all. Thank You!!
doctor
Answered by Dr. Kakkar S. 2 hours later
Brief Answer:
Regarding epidermal nevi

Detailed Answer:
Hello. Good Morning.

Thank you for writing to us
I am Dr. Kakkar (Dermatologist) and I have read your question and noted your concern.
Solitary epidermal nevi are fairly common. They may increase in length (along blashko's lines) and also become raised/ rough with growing age. There is risk of genetic transmission only if they involve the gonadal skin. Not otherwise. In the absence of underlying bone and systemic involvement they can either be simply ignored if not cosmetically concerning Or else they can be vaporised with a CO2 laser

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 1 hour later
Dr. Kakkar...thank you for calming this neurotic mom's worries! As you know I've suffered from health anxiety primarily focused on my own skin, but now I'm worried about my sons' skin!

And, as usual, despite my better judgment, I made the mistake of consulting google and stumbling upon these rare syndromes and genetic links :(

So, to sum it up, do you feel that there is no need for worry, with it being a solitary and relatively small lesion on the back of his shoulder, and my son has no health conditions or concerns? (Thanks to google and these obscure references I'll have nightmares of my son having a child someday with ichthyosis...ugh!)

Thank you immensely for being there and calming my nerves!!
doctor
Answered by Dr. Kakkar S. 23 hours later
Brief Answer:
No worries

Detailed Answer:
Hi.

No. Nothing to worry.

Regards
Above answer was peer-reviewed by : Dr. Remy Koshy
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Answered by
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Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8895 Questions

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