Photo Rounds

Growth on neck

A 13-year-old boy was brought to his family physician (FP) for a preparticipation sports physical. His mother wanted to know what the growth on his neck was and if it could be a problem. She said that the growth had been there since early childhood, and it had gotten a little darker over time. The teenager was otherwise healthy, and the remainder of his physical exam was normal.

What’s your diagnosis?


Growth on neck

The FP recognized the lesion as a linear epidermal nevus .

Epidermal nevi (EN) are congenital hamartomas of ectodermal origin that are uncommon (occurring in < 1% of newborns and children), sporadic, and usually present at birth, although they can appear in early childhood. EN are associated with disorders of the eye, nervous system, and musculoskeletal system in 10% to 30% of patients.

EN are linear, round or oblong, well circumscribed, elevated, and flat topped. EN are often yellow-tan to dark brown in color, with a surface that is uniformly velvety or warty. They most commonly occur on the head and neck, although they can occur on the trunk and proximal extremities.

The FP determined that the patient had no neurological, musculoskeletal, or vision problems that could be associated with a linear epidermal nevus syndrome and reassured the patient and his mother that the nevus was not dangerous and did not need to be removed.

Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Smith M. Epidermal nevus and nevus sebaceous. In: Usatine R, Smith M, Mayeaux EJ, et al. Color Atlas of Family Medicine , 2nd ed. New York, NY: McGraw-Hill; 2013:958-962.

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