title: NEVUS FLAMMEUS ASSOCIATED WITH DYSPLASTIC NEVI AND LICHEN SCLEROSUS: THE FIRST REPORT IN THE MEDICAL LITERATURE.
abstract: We describe a rare case of a 28 year-old male patient presenting with pruritus and increased sensitivity of the prepuce accompanied by erythematous confluent papules, unilateral nevus flammeus (NF) along almost the whole length of the right lower limb and two dysplastic nevi (DN), one located on the mid back and the other on the medial border of the right fifth toe, the latter coinciding with the NF. A biopsy of the prepuce revealed lichen sclerosus et atrophicus (LSA). Mental health assessment revealed anxiety disorder and predisposition to panic attacks. Several clinical, paraclinical and histopathological examinations were undertaken to evaluate potential underlying factors for such unusual combination of findings. Both dysplastic nevi were surgically removed. A topical calcineurin inhibitor treatment of the LSA was prescribed. For the first time in medical literature, we report an extremely rare association of NF, DN (including DN over NF) and LSA, and we are focusing our discussion on a potentially common genetic background which could explain this unusual combination of different diseases, which could in turn be caused by different mutations in common genes and/or different genes with close location in the genome.
authors.affiliation: Department "Medicinal Information and Non-interventional studies", Bulgarian Drug Agency, Sofia, Bulgaria; "Onkoderma"- Ambulatory Clinic for Dermatology and Skin Surgery, Sofia, Bulgaria; Department of General and Clinical Pathology, Medical Faculty, "Saint Kliment Ohridski University"; Dermatology Department, University Hospital of Coimbra, Praceta Mota Pinto, Portugal; Department of General and Clinical pathology, Medical University of Plovdiv, Bulgaria; Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Maximov
authors.affiliation: Department "Medicinal Information and Non-interventional studies", Bulgarian Drug Agency, Sofia, Bulgaria; "Onkoderma"- Ambulatory Clinic for Dermatology and Skin Surgery, Sofia, Bulgaria; Department of General and Clinical Pathology, Medical Faculty, "Saint Kliment Ohridski University"; Dermatology Department, University Hospital of Coimbra, Praceta Mota Pinto, Portugal; Department of General and Clinical pathology, Medical University of Plovdiv, Bulgaria; Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Chokoeva
authors.affiliation: Department "Medicinal Information and Non-interventional studies", Bulgarian Drug Agency, Sofia, Bulgaria; "Onkoderma"- Ambulatory Clinic for Dermatology and Skin Surgery, Sofia, Bulgaria; Department of General and Clinical Pathology, Medical Faculty, "Saint Kliment Ohridski University"; Dermatology Department, University Hospital of Coimbra, Praceta Mota Pinto, Portugal; Department of General and Clinical pathology, Medical University of Plovdiv, Bulgaria; Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Philipov
authors.affiliation: Department "Medicinal Information and Non-interventional studies", Bulgarian Drug Agency, Sofia, Bulgaria; "Onkoderma"- Ambulatory Clinic for Dermatology and Skin Surgery, Sofia, Bulgaria; Department of General and Clinical Pathology, Medical Faculty, "Saint Kliment Ohridski University"; Dermatology Department, University Hospital of Coimbra, Praceta Mota Pinto, Portugal; Department of General and Clinical pathology, Medical University of Plovdiv, Bulgaria; Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Cardoso
authors.affiliation: 1Department "Medicinal Information and Non-interventional studies", Bulgarian Drug Agency, Sofia, Bulgaria; 2"Onkoderma"- Ambulatory Clinic for Dermatology and Skin Surgery, Sofia, Bulgaria; 3Department of General and Clinical Pathology, Medical Faculty, "Saint Kliment Ohridski University"; 4Dermatology Department, University Hospital of Coimbra, Praceta Mota Pinto, Portugal; 5Department of General and Clinical pathology, Medical University of Plovdiv, Bulgaria; 6Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Ivanov
authors.affiliation: 1Department "Medicinal Information and Non-interventional studies", Bulgarian Drug Agency, Sofia, Bulgaria; 2"Onkoderma"- Ambulatory Clinic for Dermatology and Skin Surgery, Sofia, Bulgaria; 3Department of General and Clinical Pathology, Medical Faculty, "Saint Kliment Ohridski University"; 4Dermatology Department, University Hospital of Coimbra, Praceta Mota Pinto, Portugal; 5Department of General and Clinical pathology, Medical University of Plovdiv, Bulgaria; 6Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Wollina
authors.affiliation: 1Department "Medicinal Information and Non-interventional studies", Bulgarian Drug Agency, Sofia, Bulgaria; 2"Onkoderma"- Ambulatory Clinic for Dermatology and Skin Surgery, Sofia, Bulgaria; 3Department of General and Clinical Pathology, Medical Faculty, "Saint Kliment Ohridski University"; 4Dermatology Department, University Hospital of Coimbra, Praceta Mota Pinto, Portugal; 5Department of General and Clinical pathology, Medical University of Plovdiv, Bulgaria; 6Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Tchernev
mesh_terms: D000328:Adult; D004416:Dysplastic Nevus Syndrome / Q000150:complications* / Q000235:genetics; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000150:complications* / Q000235:genetics; D008297:Male; D009154:Mutation; D019339:Port-Wine Stain / Q000150:complications* / Q000235:genetics