A Diagnostic Challenge in Linear Dermatoses: Differentiating Inflammatory Linear Verrucous Epidermal Nevus (ILVEN) Using Dermoscopy and Reflectance Confocal Microscopy—A Case Report

Background and Clinical Significance: Inflammatory linear verrucous epidermal nevus (ILVEN) is a non-melanocytic skin lesion, typically present in early childhood, that is characterized by a linear verrucous appearance distributed along Blaschko’s lines. However, cases with onset in adolescence can present a diagnostic challenge, requiring accurate distinction from other linear dermatoses. Case Presentation: We present the case of a 16-year-old boy with a linear verrucous lesion on his thigh showing atypical clinical features. The lesion was evaluated using dermoscopy and reflectance confocal microscopy (RCM), which revealed specific diagnostic patterns consistent with the final diagnosis. Conclusions: The combined use of dermoscopy and RCM provided valuable non-invasive diagnostic information, avoiding the need for an invasive biopsy, particularly in pediatric and adolescent patients.