A 4-year-old boy presented with a linear velvety brownish plaque in the center of the nasal bridge extending slightly on the forehead and slightly over the septal demarcation of the nose (Fig. 1). It was present from birth and increased in size as the age progressed. There was no erythema or itching. A provisional diagnosis of linear verrucous epidermal nevus was kept; epidermal hyperkeratosis, acanthosis and papillomatosis were seen on histopathology – consistent with the diagnosis of epidermal nevus.

Fig. 1 Linear non-epidermolytic verrucous epidermal nervus.

Verrucous epidermal nevi are congenital, non-inflammatory, cutaneous hamartomas composed of keratinocytes. At birth they have a white, macerated appearance but within a few days take the form of pink or slightly pigmented, velvety streaks or plaques. Later, they darken and become more warty, sometimes with an erythematous base. They are distinct from inflammatory, acantholytic or porokeratotic epidermal nevi, from sebaceous nevi, and from epidermal nevi derived from skin appendages. Non-epidermolytic verrucous epidermal nevi can be differentiated clinically from other types as they are usually present at birth, and are asymptomatic, non-inflammatory and persistent.