Abstract
PURPOSE: There are few reports on the comprehensive surgical management of extensive nevus comedonicus, and the genetic mechanism of this rare disease is not yet fully understood. PATIENTS AND METHODS: We report a case of a 38-year-old woman with extensive nevus comedonicus, refractory to multiple medical treatments. She underwent comb flap reconstruction combined with super tension-relieving sutures and vacuum sealing drainage. In addition, whole-exome sequencing was performed on the lesional tissue samples. RESULTS: Nevus comedonicus was confirmed by physical and histopathological examination. Postoperative recovery was uneventful, and the patient was satisfied with the efficacy. Furthermore, no rare or deleterious mutations were detected in NEK9, FGFR2, ABCA12, or KRT10. CONCLUSION: Comprehensive surgical intervention is a viable therapeutic option for extensive nevus comedonicus refractory to medical management. Further investigation into the underlying genetic mechanisms of this disease is warranted.