A term-born male neonate presented with a linear (10 cm), verrucous, pearly white, velvety lesion extending from the right shoulder to the right cubital fossa (Fig. 1). A clinical diagnosis of linear verrucous epidermal nevus (LVEN) was made. There was no apparent systemic involvement. A biopsy could not be done as the parents refused consent. The nevus became darker and grey at the age of 6 wk on follow-up, and the baby was doing well.

Epidermal nevi are benign, hamartomal growths of skin, which may be present at birth or appear later. The condition is not hereditary but arises due to somatic mutations. LVEN may be isolated or present with involvement of other organ systems, mainly brain, eye and skeletal system to constitute epidermal nevus syndrome. These nevi are formed along the lines of Blaschko. The differential diagnoses include linear planus, psoriasis, lichen straitus and porokeratosis. Treatment modalities include surgical excision, laser, cryotherapy and topical/intralesional glucocorticoids, with varying success rates and a high risk of recurrence.