Nevus Comedonicus-Surgical Treatment for an Extensive Disease

Nevus comedonicus (NC) is a rare dermatological disorder characterized by clusters of dilated follicular openings filled with keratinous material resembling comedones. For treatments, topical retinoids, lasers, and surgical excision have varying degrees of success. This case report presents a 20-year-old patient with congenital unilateral nevus comedonicus following the blaschkoid lines extending from the right forearm including the anterior antecubital fossa, the arms, and terminating at the chest midline. The lesions progressively increased with age and were frequently complicated by secondary bacterial infections, which led to partial treatment using an invasive surgical approach which showed success. Surgical excision is the best approach for localized lesions but is not feasible for widespread region involvement. Therefore, the patient was treated using partial surgical excision and conservative management with antibiotics, which provided symptom control, though infection recurrence remains a challenge. This case highlights the multifactorial complexity in treating the nevus comedonicus.