Indian Journal of Dermatology, Venereology and Leprology Medknow Publications on behalf of The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) ISSN: 0378-6323 EISSN: 0973-3922 Vol. 76, Num. 5, 2010, pp. 563-564

Indian Journal of Dermatology, Venereology, and Leprology, Vol. 76, No. 5, September-October, 2010, pp. 563-564

Letter to the Editor

Authors' reply

Molly Thomas¹, Renu Elizabeth George¹, Meera Thomas²

¹ Department of Dermatology, Venereology and Leprosy, Christian Medical College and Hospital, Vellore, India
² Department of Pathology, Christian Medical College and Hospital, Vellore, India

Correspondence Address:
Renu Elizabeth George
Department of Dermatology, Venereology and Leprosy, Christian Medical College and Hospital, Vellore - 632 004
India
renuegeorge@gmail.com

Code Number: dv10167

DOI: 10.4103/0378-6323.69040

Sir,

We are grateful to our esteemed colleagues for their comments ^[1] on our article ^[2] and for the interest shown.

We would however like to assert that the patient described by us had an epidermolytic acanthoma of the vulva, a well-described entity, ^[3],[4],[5] in a linear pattern rather than an adult-onset verrucous epidermal nevus, as suggested, for the following reasons:

1. The articles cited ^[6],[7],[8] in the letter refer to adult-onset verrucous and inflammatory epidermal nevi and not to epidermolytic verrucous epidermal nevus. None of the reported cases had features of epidermolytic hyperkeratosis, a distinctive feature seen on histology in our patient. However, we agree that the clinical features were indistinguishable from verrucous and inflammatory linear epidermal nevi.
2. Epidermolytic verrucous epidermal nevus usually occurs at birth or in young children. ^[9],[10]
3. The onset in adulthood, the clinical features, site of occurrence and histologic features of the lesion seen in our patient were consistent with the diagnosis of epidermolytic acanthoma. ^[3],[4],[5] The linear pattern of presentation was unusual and hence the case was reported in the journal.

References

1.	Ramam M. Linear epidermolytic acanthoma or adult-onset verrucous epidermal nevus? Indian J Dermatol Venereol Leprol 2010;76:563.  Back to cited text no. 1
2.	Thomas M, George R, Thomas M. Linear epidermolytic acanthoma of vulva: An unusual presentation. Indian J Dermatol Venereol Leprol 2010;76:49-51.   Back to cited text no. 2  [PUBMED]
3.	Shapiro L, Baraf CS. Isolated epidermolytic acanthoma. Arch Dermatol 1970;101:220-3.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.	Quinn TR, Young RH. Epidermolytic hyperkeratosis in the lower genital tract: An uncommon simulant of mucocutaneous papilloma virus infection: A report of two cases. Int J Gynecol Pathol 1997;16:163-8.  Back to cited text no. 4  [PUBMED]
5.	Swann MH, Pujals JS, Pillow J, Collier SL, Hiatt K, Smoller BR. Localized epidermolytic hyperkeratosis of the female external genitalia. J Cutan Pathol 2003;30:379-81.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]
6.	Adams BB, Mutasim DF. Adult onset verrucous epidermal nevus. J Am Acad Dermatol 1999;41:824-6.  Back to cited text no. 6  [PUBMED]  [FULLTEXT]
7.	Kawaguchi H, Takeuchi M, Ono H, Nakajima H. Adult onset of inflammatory linear verrucous epidermal nevus. J Dermatol 1999;26:599-602.  Back to cited text no. 7  [PUBMED]
8.	Kosann MK. Inflammatory linear verrucous epidermal nevus. Dermatol Online J 2003;9:15.   Back to cited text no. 8
9.	Moss C, Shatidulla H. Naevi and other developmental defects. In: Burn T, Breatchnach S, Cox N, Griffiths C, editors. Rook's Textbook of Dermatology. West Sussex: Blackwell Publishers; 2010. p. 18.1-107.  Back to cited text no. 9
10.	Sarifakioglu E, Yenidunya S. Linear epidermolytic verrucous epidermal nevus of the male genitalia. Pediatr Dermatol 2007;24:447-8  Back to cited text no. 10

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