Linear psoriasis can closely mimic ILVEN, complicating diagnosis. Unlike ILVEN, linear psoriasis responds well to topical therapies. In resource-constrained settings, a histology-first approach supported by dermoscopy offers a practical and reliable diagnostic strategy. It also reduces unnecessary interventions and avoids dependence on costly, often inaccessible techniques such as immunohistochemistry.

Psoriasis is a chronic, immune-mediated dermatosis that affects approximately 125 million people worldwide. Traditionally considered a dermatologic condition, it is now perceived as a systemic disease with numerous comorbidities. While its associations with psoriatic arthritis, metabolic syndrome, and psychiatric disorders are well established, less attention has been given to its coexistence with other dermatoses. This narrative review aims to explore and summarize the existing evidence on the relationships between psoriasis and other skin diseases, highlighting potential overlaps in clinical presentation, pathogenesis, and treatment challenges. Psoriasis may coexist with several inflammatory and autoimmune skin disorders, including atopic dermatitis, lichen simplex chronicus, anti-p200 pemphigoid, pityriasis rubra pilaris, seborrheic dermatitis, inflammatory linear verrucous nevus (ILVEN), Sneddon-Wilkinson disease, and vitiligo. The review highlights the shared genetic pathways (e.g., the Th1/Th17 axis and IL-17 pathway), diagnostic challenges (e.g., sebopsoriasis and psoriasis-eczema overlap), and therapeutic considerations (e.g., paradoxical reactions to biologics and effectiveness of JAK inhibitors in both psoriasis and vitiligo). The coexistence of psoriasis with other dermatoses is more common and clinically significant than previously appreciated. Recognizing these associations is crucial for an accurate diagnosis, avoiding mismanagement, and optimizing individualized treatment strategies. Further research is needed to elucidate the underlying mechanisms and improve the multidisciplinary care for patients with complex dermatologic presentations.

Divided nevus with verrucous hyperplasia will always recur after surgery but non-verrucous divided eyelid nevus rarely recur. This study analyzed the differential expression of Ki-67, S100, Melan A and HMB45 and identified the correlation between the clinical and histopathological features of verrucous and non-verrucous divided eyelid nevus. This study included 29 patients, of whom 8 patients had verrucous divided nevus. Immunohistochemistry labeling was used to assess the expression of Ki-67, S100, Melan A and HMB45 after excision. The difference between verrucous and non-verrucous divided eyelid nevus was analyzed. The patients' ages ranged from 2 to 59 years, with a mean age of 19 years. The lesion size ranged from 1.5 to 2.0 cm in diameter and invaded the eyelid margins and the posterior lamella of the eyelids. Immunohistochemistry labeling showed strong positivity for approximately 98.5% of S100 and positive staining for approximately 27.6% of Ki-67, 72.4% of Melan A and 6.8% of HMB45. However, Ki-67 was significantly upregulated in verrucous divided nevus of the eyelids compared with non-verrucous divided nevus, with approximately 38.8% upregulation in verrucous and 18.3% upregulation in non-verrucous nevus. This study correlated the clinic-pathologic features of verrucous divided eyelid nevus by means of statistically analyzing the varied clinical features and pathological impressions. The significant over-expression of S100 may be used as an indicator of divided nevus of the eyelids, and the over-expressed Ki-67 may contribute to the recurrence of verrucous divided nevus. High expression of HMB45 and Melan A may represent malignant transformation.

Verruciform xanthoma is a rare benign proliferative lesion of the skin and mucosa which mainly affects oral mucosa. Cases of verruciform xanthomas occurring outside the oral mucosa are rare. Verrucous nevus, also called epidermal nevus, is a cutaneous hamartoma caused by abnormal proliferation of epidermal keratinocytes. Here, we reported a 39-year-old woman diagnosed verruciform xanthoma of the vulva with generalized verrucous nevus on extremities. A 39-year-old woman presented to the dermatology department. The vulva cauliflower tumor was accompanied by verrucous tumor of limbs for 33 years. The skin lesions showed cauliflower like growth in the size of fist in the perineum, and the Yellow verrucous vegetations of limbs were arranged in strips. Results The pathological diagnosis confirmed that the vulva verrucous xanthoma was combined with generalized verrucous nevus of limbs. No clinically relevant genes with pathogenic variants were detected by high-throughput sequencing technology and whole exome sequencing of genetic diseases. The pathological diagnosis confirmed that the vulva verrucous xanthoma was combined with generalized verrucous nevus of limbs. No clinically relevant genes with pathogenic variants were detected by high-throughput sequencing technology and whole exome sequencing of genetic diseases. The case was confirmed to be verruciform xanthoma, a benign proliferative xanthoma-like lesion with high incidence on the oral cavity. Combinded with generalized verrucous nevus,which is caused by excessive development of the epidermis, resulting in localized epidermal developmental abnormalities. Vulvar and peripheral lesions were treated through surgical approach. Lesions on the extremities were treated through oral administration of Acitretin capsules after obtaining informed consent from the patient. After a 3-month follow-up, the skin lesions on the hands and feet had partially disappeared. However, the outcome needs further follow-up and examination.