Massive Vulvar Linear Verrucous Epidermal Nevus Presenting at Menarche

Area of Science:

• Dermatology
• Plastic Surgery
• Pediatric Surgery

Background:

• Epidermal nevi are congenital skin hamartomas, often presenting linearly along Blaschko's lines.
• Verrucous epidermal nevi are common on the trunk and extremities, but vulvar involvement is infrequently documented.
• Management of cosmetic deformities from vulvar epidermal nevi lacks extensive evidence.

Observation:

• A case report details an 11-year-old girl with a large (9.6 × 4.5 × 3.2 cm) benign vulvar epidermal nevus.
• The patient underwent surgical excision of the nevus.
• Reconstruction was performed using a mons rotational skin flap with primary closure.

Findings:

• The surgical excision successfully removed the large vulvar epidermal nevus.
• Primary closure with a mons rotational skin flap resulted in desirable cosmetic outcomes.
• This approach demonstrates effective management for vulvar epidermal nevi.

Implications:

• Surgical excision is a viable option for large vulvar epidermal nevi.
• Rotational skin flaps and primary closure can yield excellent cosmetic results in this sensitive area.
• Further research on managing vulvar epidermal nevi is warranted to establish best practices.