Unusual Presentation of Plexiform Neurofibroma Embedded with Large Comedones: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: Introduction: gene that lead to dysregulated Ras signaling and uncontrolled cell growth. NF1 manifests with various cutaneous features, including café-au-lait macules and axillary freckling, as well as the development of neurofibromas. PNFs are particularly complex due to their extensive involvement of nerve plexuses and their potential for malignant transformation. Case Presentation: This case report documents a 42-year-old male who presented with numerous neurofibromas, café-au-lait macules, and axillary freckling. Notably, the patient had a large PNF on the right lower back, measuring 10 × 15 cm, which exhibited a "bag of worms" sensation upon palpation. Remarkably, this PNF contained multiple large comedones, each approximately 0.5 × 0.5 cm. Although histopathologic confirmation would have been valuable, a biopsy was not performed because the clinical appearance was clearly consistent with comedones, and the patient strongly refused the procedure due to pain at the lesion site. Conclusion: This case highlights an unusual presentation of PNF with large comedones, a manifestation not previously reported in the literature. The presence of comedones within a PNF emphasizes the need for thorough clinical evaluation and awareness of atypical manifestations in NF1 patients. This report contributes to the existing knowledge and underscores the importance of recognizing rare dermatological presentations to prevent misdiagnosis and ensure appropriate management.
Source: Case Reports in Dermatology
DOI: 10.1159/000548908
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,030
OpenAlex ID: W7124168248