Verrucous Surface Research Articles

Human Papillomavirus-Associated Oral Epithelial Dysplasia: Report of 5 Illustrative Cases from Latin America.

Human papillomavirus-associated oral epithelial dysplasia (HPV-OED) is a distinct oral epithelial disorder characterized by viral cytopathic changes caused by transcriptionally active high-risk HPV. The aim of the present study was to report 5 additional cases from Latin America. Clinical data from five patients with HPV-OED were obtained from the archives of three oral pathology services from Brazil and Chile. All cases were submitted to morphological, p16 expression and in situ hybridization (ISH) for HPV analyses. Four patients were male and one patient was female, with a mean age of 55.4 years. Four patients were HIV seropositive and two were smokers. Three cases affected the buccal mucosa and commissure, one of which had an additional plaque in the soft palate, and one case each occurred on the floor of mouth and lower labial mucosa. Most cases presented as well-demarcated white plaques with a verrucous surface. One case presented multiple lesions ranging from normal to white-colored slightly elevated plaques with a cobblestone surface. Peripheral mucosal pigmentation was observed in two cases. All five cases presented with the characteristic microscopic features of HPV-OED, including severe dysplasia with numerous karyorrhectic and apoptotic cells, full-thickness "block positivity" for p16 and high Ki-67 index (> 90%) sharply demarcated from the adjacent non-dysplastic epithelium. Wide-spectrum DNA ISH-HPV was positive in 4 cases. All patients were treated with conservative surgical excision with no signs of recurrence after a mean of 39-month follow-up. This represents the first series of HPV-OED from Latin America; most cases presented as well-demarcated papillary white plaques affecting the buccal mucosa and commissure of HIV-positive middle-aged men, two of them exhibiting peripheral pigmentation caused by reactive melanocytes. The typical microscopic findings of HPV-OED were observed in all cases, which also showed strong p16 positivity in a continuous band through the full thickness of the epithelium and high Ki67.

Dermoscopic Features of Blue Rubber Bleb Nevus Syndrome

Abstract Blue rubber bleb nevus syndrome (BRBNS) usually has a sporadic onset. It is characterized as blue to purple, soft, rubbery, compressible nodules over any region in the skin or mucous membrane. It may be complicated by acute hemorrhage, iron deficiency anemia, bowel infarction, skeletal bowing, pathologic fracture, etc., Here, we present the case of a 9-year-old boy who presented with a complaint of multiple reddish to bluish nontender nodules over the tongue, chest, neck, abdomen, back, B/L upper limb, scrotum, and B/L lower limb including sole. Dermoscopic examination demonstrated red–purple globules with verrucous surface with lacunae separated by a white linear structure corresponding to fibrous demarcations. With the help of dermoscopic and clinical examination, the patient was diagnosed as having BRBNS.

CONVENTIONAL SQUAMOUS CELL CARCINOMA COEXISTING WITH A VERRUCOUS CARCINOMA: A HYBRID NEOPLASM

Verrucous carcinoma (VC) is a low-grade variant of squamous cell carcinoma (SCC) that lacks the cytological features of malignancy and does not metastasize, differently from the conventional SCC. Oral hybrid verrucous carcinoma is a rare neoplasm comprised of VC and conventional SCC. This study presents a case report of this hybrid neoplasm in an 81-year-old male former smoker. In the intraoral examination, the patient exhibited a white lesion with a verrucous surface in the maxillary alveolar ridge. Under clinical hypothesis of VC or conventional SCC, an incisional biopsy was performed. Microscopically, the tumor showed an endophytic proliferation of hyperkeratinized squamous epithelium with parakeratin plugging and bulbous rete ridges extending in depth. Areas of infiltration by trabeculae and islands of well-differentiated SCC were also observed. The final diagnosis was SCC coexisting with a hybrid verrucous carcinoma (VC). The patient was referred to a head and neck service and is undergoing treatment. Verrucous carcinoma (VC) is a low-grade variant of squamous cell carcinoma (SCC) that lacks the cytological features of malignancy and does not metastasize, differently from the conventional SCC. Oral hybrid verrucous carcinoma is a rare neoplasm comprised of VC and conventional SCC. This study presents a case report of this hybrid neoplasm in an 81-year-old male former smoker. In the intraoral examination, the patient exhibited a white lesion with a verrucous surface in the maxillary alveolar ridge. Under clinical hypothesis of VC or conventional SCC, an incisional biopsy was performed. Microscopically, the tumor showed an endophytic proliferation of hyperkeratinized squamous epithelium with parakeratin plugging and bulbous rete ridges extending in depth. Areas of infiltration by trabeculae and islands of well-differentiated SCC were also observed. The final diagnosis was SCC coexisting with a hybrid verrucous carcinoma (VC). The patient was referred to a head and neck service and is undergoing treatment.

CORRELATION BETWEEN EPITHELIAL DYSPLASIA AND ORAL SQUAMOUS PAPILLOMA AS A RESULT OF MULTIPLE RISK FACTORS: A CLINICAL CASE

This study is a clinical case of a 64-year-old leukoderma female patient, smoker for more than 45 years, who, after being diagnosed with Hepatitis A and B in different periods, presented a single leukoplastic, verrucous, pedunculated nodule, of the "cauliflower" type, on the lower alveolar edge of the right side (lesion I). It also presented homogeneous leukoplastic plaque, with verrucous surface, in the region of the lateral border of the tongue on the left side (lesion II). Both lesions were asymptomatic, with an undefined onset. The probable diagnostic hypotheses were squamous papilloma (lesion I) and leukoplakia (lesion II), with a differential diagnosis of condyloma (lesion I) and lichen planus (lesion II). Biopsy was performed by excisional removal of lesion I and incisional removal of lesion II, with the diagnosis of oral squamous papilloma and moderate to severe oral epithelial dysplasia, respectively. There was no radiographic lesion. Patient is undergoing follow-up. This study is a clinical case of a 64-year-old leukoderma female patient, smoker for more than 45 years, who, after being diagnosed with Hepatitis A and B in different periods, presented a single leukoplastic, verrucous, pedunculated nodule, of the "cauliflower" type, on the lower alveolar edge of the right side (lesion I). It also presented homogeneous leukoplastic plaque, with verrucous surface, in the region of the lateral border of the tongue on the left side (lesion II). Both lesions were asymptomatic, with an undefined onset. The probable diagnostic hypotheses were squamous papilloma (lesion I) and leukoplakia (lesion II), with a differential diagnosis of condyloma (lesion I) and lichen planus (lesion II). Biopsy was performed by excisional removal of lesion I and incisional removal of lesion II, with the diagnosis of oral squamous papilloma and moderate to severe oral epithelial dysplasia, respectively. There was no radiographic lesion. Patient is undergoing follow-up.

Electrosurgery on Giant Condyloma Acuminata

Giant Condyloma Acuminata (GCA) is a sexually transmitted infection caused by Human papillomavirus (HPV) types 6 and 11. GCA lesions can growth up to 10 cm and form like a cauliflower shape. This infection can affect patient’s quality of life. The goal of therapy in GCA is to remove all skin lesions, which can be done by surgical treatment. Many modalities have been tested in GCA cases, one of which is electrosurgery. The aim of this study was to evaluate effectiveness of electrosurgery for GCA. A 43-year-old woman came with complaints of warts appeared in the genital area since 3 months before. Examination showed multiple papules with a verrucous surface, size around 7 cm in the labia majora, labia minor and perineum. The acetowhite examination and histopathology lead to the diagnosis of condyloma acuminata. Electrosurgery (electrodesication) to remove GCA lesions divided into 2 times. Post-operative evaluation, patient did not complain of pain and erythema, edema, and pus. Electrosurgery is a therapeutic modality that can be chosen in cases of GCA. Electrosurgery, like other surgical modalities, is capable of removing the entire lesion, but the advantages of electrosurgery include not injuring large areas, minimal bleeding and a lower recurrence rate when compared to other therapeutic modalities.

Case Report: Combination Therapy of Electrocautery and Zinc Sulfate in Perianal Giant Condylomata Acuminata with Human Immunodeficiency Virus (HIV)

Introduction: Giant Condylomata Acuminata (GCA) or Buschke-Lowenstein tumours are rare variations of anogenital warts. Immunocompromising conditions are closely related to the development of GCA. There is no standard therapy in the management of GCA. Its large size allows malignant transformation and high recurrence. Case Presentation: A male, 26 years old, with a complaint of wart in the anal in the last 11 months. The lump was getting bigger and sometimes bleed. The patient had been diagnosed with HIV 1 year ago and had received routine antiretroviral therapy (ARV). On physical examination of the perianal region showed stalked vegetation which was hypopigmented, partly erythema, verrucous surface, in the form of cauliflower, multiple, measuring 1.5x1.5x4 cm. A positive acetowhite test and histopathological examination showed condylomata acuminata. Patients were given combination electrocautery therapy and zinc sulfate 5-10 mg/kg/day for 2 months. Significant improvement appears and GCA disappears entirely. Conclusion: Electrocautery and zinc sulfate as an immunomodulator can be considered as a treatment of GCA with HIV because they can work synergistically to achieve resolution of the lesion and prevent recurrence of GCA.

Penile Intraepithelial Neoplasia (PeIN) in a young man with the clinical appearance of Buschke Lowenstein Tumor

Background: The incidence of penile cancer in the general population is rare. Epidemiologically, penile cancer occurs less than 1% compared to other types of cancer. Penile Intraepithelial Neoplasia (PeIN) is a precancerous lesion of invasive squamous cell carcinoma characterized by dysplastic changes of squamous epithelium with the intact basement membrane. This case report aims to increase understanding of Penile Intraepithelial Neoplasia (PeIN), especially with the clinical appearance of the Buschke Lowenstein Tumor, diagnosis, examination, and appropriate management. Case Presentation: A 21-year-old Balinese man presented with a lump on his genitalia without itching, pain, and a lesion that bleeds easily, which has appeared since January 2022. He complained that the lump was getting bigger and bigger. Physical examination showed multiple hyperpigmented papules and plaques with well-defined oval and corn shapes that vary in size with a dense consistency and a verrucous surface. Laboratory tests showed negative on Hep-B and HIV tests. The patient also had a biopsy of the lump where the results showed Penile Intraepithelial Neoplasia. The patient was treated with 6 cycles of TCA 80% once a week, but it did not improve, so circumcision and surgical excision were carried out on June 2022. Fourteen days after surgery, multiple lumps appeared, recurred, and increased in number and size. On 1-month observation after the second surgery, the patient denied complaints of the genitals. Venerological status was within normal limits. Conclusion: HPV-related Penile Intraepithelial Neoplasia (Warty subtype) with the clinical appearance of Buschke Lowenstein Tumor was reported in a 21-year-old Balinese man treated with Glans Resurfacing surgical excision with satisfactory results characterized by no functional abnormalities both during urination or erection.

On the exine ultrastructure of fossil ginkgoaleans: In situ pollen of Sorosaccus Harris

The morphology and exine ultrastructure have been studied of pollen grains from pollen cones of Sorosaccus sibiricus Prynada from the Ust’-Baley (Aalenian, Siberia), Sorosaccus sp. from the Vladimirovka (Aalenian-Bajocian, Siberia), and S. ex gr. sibiricus Prynada from the Tyrma (Tithonian–Berriasian, Russian Far East) localities. The pollen grains are boat-shaped and monosulcate. A finely granulate pattern is discernible under high magnification of light microscope in pollen grains from Vladimirovka and Tyrma; SEM shows that this pattern is formed by flat verrucae. TEM shows that sculptural elements are present on the surface of pollen grains from Ust’-Baley, although it is not evident in LM and SEM. By previous data on modern and fossil members, we believed that ginkgoalean pollen grains can be differentiated from similar boat-shaped monosulcate pollen of other affinities by a ratio of ectexinal sublayers (a thick homogeneous tectum, a thin infratectum of one row of structural elements, and a thin foot layer) in combination with an ectexine that is greatly reduced in the aperture region. Freshly obtained data have revealed another set of characters, with a less prominent tectum by comparison to underlying sublayers, an infratectum with small granules within the alveoli, and a prominent verrucate surface pattern that is distinguishable even in transmitted light. Ginkgoaleans are characterized by more than one set of ultrastructural characters of the exine.

MANAGEMENT OF VERRUCOUS EPIDERMAL NEVI WITH KSHARAKARMA: A CASE REPORT

Verrucous Epidermal Nevi (VEN) are congenital, non-inflammatory cutaneous hamartomas occurring as a result of excessive proliferation of the keratinocytes. Available treatment options are ineffective and recurrences are common. A 66-year-old housewife, presented with complaints of well-defined hypopigmented plaque with verrucous surface on scalp noticed since birth and gradually increasing in size. Initially asymptomatic but since last one year had complaints of itching with loss of patchy hair over the plaque. Incision biopsy taken from the plaque confirmed the case as a verrucous epidermal nevus. The patient was treated with six sittings of Ksharakarma for a period of 3 months. After 3 months of treatment the plaque resolved completely and there was no recurrence noted during 2 years of follow-up. The present case report proves that Ksharakarma, an Ayurvedic parasurgical modality is a better alternative treatment option for VEN.

Prediction of malignant transformation and recurrence of oral epithelial dysplasia using architectural and cytological feature specific prognostic models

AbstractOral epithelial dysplasia (OED) is a precursor state usually preceding oral squamous cell carcinoma (OSCC). Histological grading is the current gold standard for OED prognostication but is subjective and variable with unreliable outcome prediction. We explore if individual OED histological features can be used to develop and evaluate prognostic models for malignant transformation and recurrence prediction. Digitised tissue slides for a cohort of 109 OED cases were reviewed by three expert pathologists, where the prevalence and agreement of architectural and cytological histological features was assessed and association with clinical outcomes analysed using Cox proportional hazards regression and Kaplan–Meier curves. Within the cohort, the most prevalent features were basal cell hyperplasia (72%) and irregular surface keratin (60%), and least common were verrucous surface (26%), loss of epithelial cohesion (30%), lymphocytic band and dyskeratosis (34%). Several features were significant for transformation (p < 0.036) and recurrence (p < 0.015) including bulbous rete pegs, hyperchromatism, loss of epithelial cohesion, loss of stratification, suprabasal mitoses and nuclear pleomorphism. This led us to propose two prognostic scoring systems including a ‘6-point model' using the six features showing a greater statistical association with transformation and recurrence (bulbous rete pegs, hyperchromatism, loss of epithelial cohesion, loss of stratification, suprabasal mitoses, nuclear pleomorphism) and a ‘two-point model' using the two features with highest inter-pathologist agreement (loss of epithelial cohesion and bulbous rete pegs). Both the ‘six point' and ‘two point' models showed good predictive ability (AUROC ≥ 0.774 for transformation and 0.726 for recurrence) with further improvement when age, gender and histological grade were added. These results demonstrate a correlation between individual OED histological features and prognosis for the first time. The proposed models have the potential to simplify OED grading and aid patient management. Validation on larger multicentre cohorts with prospective analysis is needed to establish their usefulness in clinical practice.

EXTENSIVE VERRUCOUS CARCINOMA IN ORAL CAVITY: CASE REPORT

A 63-year-old female patient reported increased volume in the face with a 5-year evolution. On extraoral physical examination, a tumor lesion was observed in the right labial commissure, in addition to a fistula in the ipsilateral mandibular region. In the oral cavity, an extensive vegetating lesion with a verrucous surface was observed, covering the commissure and labial and buccal mucosa up to the retromolar region on the right side, with areas of bleeding and necrosis. Computed tomography revealed expansive formation, covering the cutaneous area with an extension to the lips showing proximity to the maxillary alveolar ridge and mandible body without signs of bone erosion. Incisional biopsy was performed and the anatomopathologic analysis was conclusive for verrucous carcinoma. In view of the impossibility of surgical treatment, we opted for radiotherapy, 35 sessions totaling 70 Gy concomitant with chemotherapy with cisplatin. The patient underwent 10 radiotherapy sessions and is being followed up.

Adult-onset severe acral angiokeratoma-like pseudolymphoma: A case report and review of the literature.

Adult-onset severe acral angiokeratoma-like pseudolymphoma: A case report and review of the literature.

Significance of seed morphology and anatomy in the systematics of Musaceae

AbstractThe paper deals with the seed morphology and anatomy of 32 wild Indian Musaceae by using light microscopy (LM) and scanning electron microscopy (SEM). This is the first comprehensive investigation into the seed micro-morphological and anatomical aspects of two genera of the family. Seed characters including shape, size, surface sculpturing (LM and SEM), seed coat thickness, layer characters and chalazal chamber column were considered. Seed characters play a significant role in the delimitation of taxa as they are more stable than vegetative (anatomical) and pollen features. Four types of seeds (oblate, ovoid, sub-globose and ellipsoid) were observed in the family, oblate seeds being the most common. LM revealed that most of the seeds have verrucate surface sculpturing, but some are smooth-verrucate or smooth. Seed size also plays an important role in the identification of the taxa to some extent. Number of layers and seed coat thickness are directly proportional to seed size. However, the thickness of endotesta, tegmen and inner endosperm layers (aleurone layers) differ in small and large seeds. The present study revealed eight types of outer sculpturing and three inner sculpturing patterns with diverse nature of anticlinal and periclinal cell walls. Based on the seed characters, a phenetic analysis was also carried out.

Human Papillomavirus High-risk Type Infection on Perianal Giant Condyloma Acuminatum

Background: Giant condyloma acuminatum (GCA) is a large form of condyloma acuminatum that become locally invasive, destructive, but non-metastasizing, caused by human papillomavirus (HPV). Giant condyloma is a rare disease, with only 0.1% incidence in the general population. Most commonly caused by HPV type 6 and 11 infections, in this case, reported HPV high-risk type.&#x0D; Case presentation: A 20-years-old man, the main complaint is enlarging, easy bleeding perianal tumor with pruritus and constipation for 2 months. Physical examination found skin-colored, verrucous surface. Some have smooth surface, cauliflower-like tumor on perianal region, size 7x4x2cm. Syphilis and HIV Serology laboratory tests are non-reactive. Koilocytes appear on histopathologic examination. High-risk HPV type detected on HPV genotyping. This patient was diagnosed as GCA. Topical agent 25% podophyllin tincture applied to the lesions once a week. Improvement appears after eighth-time therapy.&#x0D; Discussion: High-risk type HPV infection, detected in the patient, have an important role in GCA development. Decreased immune system and other risk factors also have a role in GCA.

Management of verrucous hyperplasia involving the buccal mucosa using the buccal fat pad: A case report

Verrucous hyperplasia (VH) is a rare and potentially malignant exophytic oral mucosal lesion with a verrucous or papillary surface. VH has a tendency to transform into its malignant counterpart, verrucous carcinoma, which is clinically indistinguishable, yet histologically variable. The most common site of predilection is the buccal mucosa and VH more prevalent in patients with habits of areca nut chewing or smoking. A biopsy of the lesion with the surrounding normal mucosa and adequate depth should be performed to histopathologically to diagnose the condition and provide treatment management accordingly. The present study describes the case of a 37‑year‑old male with VH of the buccal mucosa that was successfully managed by surgical excision and reconstruction using the buccal fat pad (BFP). BFP was used due to its higher vascularity, its proximity to the donor site and to provide less scar contracture. The patient was followed up regularly and the surgical site was health with uneventful healing and complete mucolisation.

Morphological study of modern phytolith assemblages in guinea Sahara region of Nigeria

Morphological study of phytolith was carried out from 11 plant species in 10 different plant families in Nigeria.Fresh plant leaves were randomly collected each from family which consists of leaves from 11 species for phytolith analysis. Schulze’s solution was the standard method used to extract phytolith from the sample. The extracted samples were examined with Olympus Bx41 microscope. Phytolith results revealed a wide range of phytolith morphotypes with considerable degree of variability. However, 9 species were reported to have cuneiform bulliform phytolith shape, 1 bilobate phytolith shape and 1 reported globular echinate phytolith shape. Psilate and verrucate surface texture was observed from the study. These results of phytolith analysis could serves as baseline data that represent the modern vegetation assemblage of the study area for future paleoenvironmental study and environmental reconstruction.

Genç Bir Erkekte Greft Bölgesinde Seboreik Keratoz

Seborrheic keratosis are common, benign epidermal tumours that present as asymptomatic, pigmented papules with a stuckon appearance. Stucco keratosis is a type of seborrheic keraosis which has a scaly verrucous surface and can be scrapped off by scratching. Seborrheic keratosis is usually associated with advancing age and ultraviolet light exposure. Herein, we describe a case of stucco keratosis present only over the full thickness skin graft site in a young male. The tumours developed soon after skin grafting was done for a defect produced after a road traffic accident. Skin grafts are associated with skin barrier dysfunction and lymphatic compromise which may produce immunocompromised cutaneous districts and lead to seborrheic keratosis.

Giant Condyloma Accuminata in Pregnancy, Use of Trichloroacetic Acid combined with electrocauterization and excision Procedure: A Case Report

Condyloma acuminata is a sexually transmitted disease caused by the Human Papilloma Virus (HPV). During pregnancy, condyloma acuminata can proliferate rapidly due to changes in immunity and increased blood supply. One of the safest therapeutic modalities is trichloroacetic acid (TCA). Electrocautery is another modality in pregnant patients. A 16-year-old woman, 6-months pregnant, complained of a wart-like lump in the pubic area getting more prominent since the last two weeks and covering the vagina surface. The lump is not itchy and painless. From history-taking it was found that patient often changes partners. On physical examination, the lesions were multiple papules with a verrucous surface. The results of the work-up showed a positive acetowhite test. Patients are then treated with a TCA of 80-90% during pregnancy and followed by electrocautery and excision during cesarean section. The results of 80-90% TCA treatment followed by electrocautery and excision were satisfactory, and there were no recurrences when the patient went for a follow-up. TCA is a substance that is caustic and can erode skin and mucous membranes. TCA works by coagulation of proteins which causes dryness of cells and tissues. TCA is safe for pregnant women. Combination of TCA 80-90% with electrocautery and excision, in this case, proved to be effective with no sign of recurrence. The combination of TCA therapy with electrocautery and excision has proven effective and safe for pregnant patients.

Clinical Appearance Of Tinea Corporis Resembles With Tinea Imbricata And Condyloma Acuminata Genital In A Reproductive Woman With HIV : A Case Report

Background: HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system that can cause immunodeficiency. Immunodeficiency results in increased susceptibility to fungal infections. The other opportunistic infection, condyloma acuminate is prevalent in groups at high risk for HIV acquisition and in HIV-infected individuals. Case: There were ring-shaped reddish patches with scaly and itchy on the right back since 3 weeks ago. Patients often scratch it especially when sweating and hot weather. The itchy reddish patches with scaly were increased in number and size on the right back then spreading over the edge to form ring-like patches. Patient complained ring-shaped reddish patches getting more red, scaly, itchy, and wider. 6 months ago, there was a lump that sometime felt itchy in below part of vulva. Patient in reproductive age and not married yet, but sexually active. Patient had a sexual relation with male who HIV 2 years ago. Patient also suffered HIV and got ARV since 6 month ago. There was no protection (condom) during the sexual intercourse. Dermatologic state in right back with efflorescence is plaque erythema with annular concentric ring forms, scale, and blackish crust. Venereologycal state show vegetation in vulva with size 0,2 - 1,5 x 1 x 0,5 cm with verrucous surface. Acetowhite test is positive result. KOH 10% of skin scrapping show fungal element and fungal culture result is tricophyton rubrum. Patient was diagnosed tinea corporis (TC) and condyloma acuminata (CA) genital griseovulfin 900 mg, cetirizin 10 mg, ketokonazol 2% cream twice a day, tricholoroacetat 90% and showed good improvement.Discussion: Diagnosis tinea corporis and CA genital based on clinical findings and mycological examination. Early diagnosis and proper treatment are important in HIV patients in order to prevent severe infection. After 4 weeks treatment, show improvement on TC however CA lesion no reduced. Keywords: tinea corporis,condyloma acuminate, tinea imbricata, HIV, Reproductive age

Dermoscopy-guided carbon dioxide laser destruction for nevus sebaceous: two case reports

Background: Nevus sebaceous (NS) is a common hamartoma of the cutaneous adnexal structure, clinically appear as a well demarcated yellow-orange plaque, sometimes with verrucous surface. Dermoscopy may aid the diagnosis of NS and also guide carbon dioxide (CO 2 ) laser therapy. Case Illustration:&nbsp; Two cases of brown and yellowish plaque on the face, with clinical appearance, dermoscopic, and histopathological findings consistent with NS. The patients consented to undergo serial CO&shy; 2 laser destruction, aimed to reduce recurrences and shorten the duration of the downtime. Dermoscopy aided in locating the area and the depth of each treatment. Discussion:&nbsp; The dermoscopy finding of NS were already reported as milia-like structure and multiple whitish structures (dots) varying in size, with orange background. The dermoscopy findings of these two cases were in accordance with previous reports. CO 2 laser destruction was reported to produce satisfying results, but with known recurrences.&nbsp;&nbsp;With the knowledge of dermoscopy appearance, we could determine the area and depth of the lesion to prevent reoccurrence. After two years of follow-up, the area where the deep ablation was performed had not reoccurred.&nbsp; Conclusion:&nbsp; Dermoscopy may aid the diagnosis and therapeutic confirmation of NS.&nbsp; &nbsp; Keywords :&nbsp; dermoscopy, sebaceous nevus, serial CO 2 laser &nbsp;