Defects, central nervous system abnormalities or other extra-cutaneous ailments (nevus comedonicus syndrome). While most cases of nevus comedonicus happen unilaterally around the face, neck and chest, the lesions sometimes show a bilateral distribution (bilateral nevus comedonicus). We report here an unusual case of bilaterally disseminated nevus comedonicus with a variety of systemic complications. A 62-yearold Japanese man presented having a 50-year history of numerous keratotic papules and comedo-like lesions, which gradually worsened with time. Physical examination revealed that the papules had been skin-colored and 1? mm in diameter. Some papules had dark-black keratinous components on their surface, giving them a comedolike appearance. The lesions were situated predominantly around the face, head, neck and trunk with symmetric distribution, following Blaschko’s lines. The patient’s previous healthcare history was noteworthy; he had undergone surgical treatments for thyroid cancer, pneumothorax and schwannoma inside the cauda equina. He also suffered from scoliosis, cervical spondylosis and atrial fibrillation. Histopathologic examination revealed dilated and invaginated follicular structures filled with lamellar keratin, compatible with nevus comedonicus. Our patient’s case did not fit with any previously reported diseases, and we thought a diagnosis of “bilateral nevus comedonicus syndrome” was by far the most proper for our patient’s condition. He was treated with topical retinoic acid and activated vitamin D3 ointment for three months each, but the lesions remained unchanged.Crucial words nevus comedonicus; nevus comedonicus syndrome; schwannoma; thyroid tumorfices filled with keratinous material.1 In some instances, nevus comedonicus is complicated with other conditions, for instance cataracts, skeletal defects, central nervous program abnormalities or a variety of other non-cutaneous situations (nevus comedonicus syndrome).two Though most situations of nevus comedonicus happen unilaterally around the face, neck and chest, they sometimes show a bilateral distribution (bilateral nevus comedonicus).N-(Azido-PEG3)-N-(PEG2-NH-Boc)-PEG3-acid structure 3 We report here an uncommon case of bilaterally disseminated nevus comedonicus with several systemic complications.1245647-53-3 site PATIENT REPORTA 62-year-old Japanese man was referred to our hospital using a 50-year history of a lot of keratotic papules and comedo-like lesions, which progressively worsened with time.PMID:25269910 Physical examination revealed that the papules were skin-colored and 1? mm in diameter. Some papules had dark-black keratinous components on their surface, giving them a comedo-like appearance. The lesions have been positioned predominantly on the face, head, neck and trunk with symmetric distribution, following Blaschko’s lines (Fig. 1). Extremities, which includes hands, feet and nails, also as mucous membranes had been spared. The patient did not complain of any symptoms. Family history and routine laboratory studies had been unremarkable, while his previous healthcare history was noteworthy; he had undergone surgical remedies for thyroid cancer, pneumothorax and schwannoma within the cauda equina. He has also suffered from scoliosis, cervical spondylosis and atrial fibrillation. We performed punch biopsy with the lesion around the neck. Histopathologic examination revealed dilated and invaginated follicular structures filled with lamellar keratin, in accordance with all the capabilities of nevus comedonicus (Fig. two). Determined by these findings, we thought a diagnosis of “bilateral nevus comedonicus syndrome” was one of the most proper for ou.