Exploring clustered comedones: Investigating rare cases of nevus comedonicus: An observational study.

Introduction: Nevus comedonicus (NC), a rare developmental anomaly in the pilosebaceous unit, is characterized by grouped, dilated follicular orifices filled with keratinous material. NC is usually solitary but may be part of nevus comedonicus syndrome with extracutaneous abnormalities. This study aimed at comprehensively analyze and meticulously document demographic data, clinical presentations, and patterns of cutaneous involvement, concurrent dermatologic or systemic conditions, and complications. Methods: An observational study was conducted at a tertiary health centre for the period of one year. This study included patients clinically diagnosed with nevus comedonicus and subjected to further evaluation to rule out systemic involvement and pattern of cutaneous involvement and associated complication in these patients were recorded. Results: The study included nine patients diagnosed with nevus comedonicus, showing slight female preponderance and predominantly affecting the face. Clinical manifestations varied from asymptomatic to inflammatory or lesions leading to secondary complications such as bacterial superinfection, cyst formation in a few patients, and scarring in all the patients. All patients had single area of involvement, while the pattern of cutaneous involvement was mainly dermatomal in five patients. All patients had cosmetic disfigurement to some extent. No patient had any abnormalities of the eyes, skeleton, or central nervous system. None of the patients showed spontaneous resolution of nevus comedonicus, and lesions persisted after evolution. Therapeutic interventions offered to patients included a spectrum of modalities, including topical retinoids, keratolytics, systemic antibiotics, and surgical approaches such as incision and drainage of cysts, laser therapy, or surgical excision. Conclusion: Nevus comedonicus is a rare cutaneous hamartoma with clustered, dilated pits filled with soft, black keratin. The study highlights demographic data, clinical presentations, and complications. Therapeutic options are variable, necessitating further research to understand the underlying pathophysiology and develop more effective treatments.