The subject case of this report is a 22-year-old female patient with Verrucous Linear Epidermal Nevus (VLEN) who underwent Er:YAG laser resurfacing. The lesion unilaterally affected the external side of the upper left arm from the cubital space to shoulder, the left mammary region, the left neck region, and the left part of the back from the shoulder to the gluteal region. Several dermatological treatments were previously performed without significant results. Prior to laser treatment, skin biopsies were taken and histopathology examinations showed hyperkeratosis, papillomatosis and acanthosis with elongation of the rete ridges, with no pigmentary incontinence or dermal abnormalities. We performed resurfacing with a 2940 nm Er:YAG laser with percutaneous local anesthesia. After lasing in the cold ablation regime, the vaporized, atypical, disorganized epidermal cells were replaced with normal, well-organized keratinocytes from the follicular adnexa. The Er:YAG resurfacing technique provided complete removal of the lesion in two treatments, which was very important considering the large surface treated.
This case clearly shows the benefit of Er:YAG laser ablation as a highly precise, simple, and effective method for treating VLEN.