Verruciform xanthoma: a special epidermal nevus.

[child syndrome]

Congenital hemidysplasia with ichthyosiform nevus and limb defects (CHILD ) syndrome is a rare X-linked hereditary disorder . Presentation varies from ichthyosiform nevus to complete limb amelia . We present a 17 -year -old adolescent girl who presented with a 16 -cm exophytic mass of the right foot that had been growing for 7 years as well as knee contracture . Deformed nails with onychorrhexis were noted bilaterally . History of multiple nonlinear erythematous skin lesions covered by dry waxy scales involving multiple body folds with sharp midline demarcation was obtained . The patient 's family history was negative for consanguinity and similar conditions . Radiography showed right leg hypoplasia and osteopenia . These findings fulfill the diagnosis of CHILD syndrome . Microscopically , psoriasiform epidermal hyperplasia with marked orthohyper-keratosis and neutrophilic exocytosis were noted . The papillary dermis was packed with foamy macrophages consistent with xanthomatous changes , namely verruciform xanthoma . Verruciform xanthoma , although rarely found in other conditions , is a characteristic finding .