10.5826/dpc.1201a09
text/xml
2160-9381
1628
en
Adrián Imbernón-Moya
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Nevoid Acanthosis Nigricans Located on the Scalp
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2022-02-02
2021-01-05
2022-02-02
2022-02-09
e2022009
Dermatol Pract Concept
Adrián Imbernón-Moya
2022/02/02
10.5826/dpc.1201a09
e2022009
Dermatology Unit, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
2160-9381
en
e2022009
Piccolo V, Russo T, Picciocchi R, Errico M, Ametrano O, Moscarella E. Generalized idiopathic benign acanthosis nigricans in childhood. Ann Dermatol. 2013;25(3):375-377. DOI: 10.5021/ad.2013.25.3.375. PMID: 24003287. PMCID: PMC3756209.
Nevoid Acanthosis Nigricans Located on the Scalp
https://dpcj.org/index.php/dpc/article/download/1628/1485
  Nevoid Acanthosis Nigricans Located on the Scalp
  Jorge Román-Sainz1, Nicolás Silvestre-Torner1, Sergio Samer Tabbara-Carrascosa1, Adrián
                                     Imbernón-Moya1


1 Dermatology Unit, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain



Citation: Román-Sainz J, Silvestre-Torner N, Tabbara-Carrascosa SS, Imbernón-Moya A. Nevoid acanthosis nigricans located on the scalp.
Dermatol Pract Concept. 2022;12(1):e2022009. DOI:https://doi.org/10.5826/dpc.1201a09
Accepted: May 6, 2021; Published: January 2022
Copyright: ©2022 Román-Sainz et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Jorge Román-Sainz, Dermatology Unit, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain.
E-mail: jorgesheldon@gmail.com




Case Presentation                                                             The closest differential diagnosis is with epidermal ne-
                                                                         vus. Although they are clinically very similar, RAVEN is
A 14-year-old male presented with an alopecic plaque in his              usually velvetier, and histology plays an essential role as it
occipital area. Skin exam revealed a well-defined, hyperpig-             shows compact hyperkeratosis, papillomatosis and limited
mented plaque with a velvety texture, resembling acanthosis              acanthosis as compared to epidermal nevi. Other differential
nigricans (AN) (Figure 1A). Trichoscopy showed broken hair               diagnosis include confluent and reticulate papillomatosis,
shafts and yellow dots, as well as a few exclamation mark                ichthyosis hystrix, and the hyperkeratotic type of seborrheic
hairs. Histology manifested mild acanthosis, hyperkerato-                keratosis. In our case, the velvety texture of the lesion, as
sis, and papillomatosis, with no visible nests of melanocytes            well as the histology, which showed mild acanthosis, ex-
(Figure 1B). Due to these findings, the patient was diagnosed            cluded epidermal nevus.
with nevoid AN. This skin disorder, also known as RAVEN
(round and velvety epidermal nevus) is a rare entity, which
appears at or before puberty [1,2].
                                                                         Teaching Point
    The skin disorder RAVEN has no predilection for inter-               RAVEN can resemble epidermal nevi or AN. Dermatologists
triginous or flexural areas. Most reported cases are unilateral          should be aware of this entity and should consider it in the
and located on the chest, abdomen and umbilical, or retroau-             differential diagnosis of pigmented skin lesions.
ricular area. We found no other reports of RAVEN involving                    Informed consent: Informed consent for publication of
the scalp in the literature. As it is a benign condition, RAVEN          clinical details and clinical images was obtained from the
requires no treatment or follow-up, and has not been found               patient.
to be associated with any underlying disorder [1,2].




Image Letter | Dermatol Pract Concept. 2022;12(1):e2022009                                                                            1
Figure 1. (A) Well-defined, hyperpigmented plaque located in the occipital area of the patient, associated with loss of hair density.
(B) H
    ­ istology showing elongated papilla (yellow arrow), acanthosis (green arrow), hypergranulosis (blue arrow) and hyperkeratosis (orange
arrow). Melanosis (red arrow) is also visible in some areas.




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