The lesions were soft, skin colored and non-tender. The lesions caused no symptoms except for an unsightly appearance. There was no family history of similar lesions. Physical examination revealed several skin-colored, well-defined, soft and sessile growths with a cerebriform surface with centrally located comedo-like plugs that spread over an area of approximately 12×4 cm on the right

gluteal region. There was no ulceration, excessive hair growth, pigmentation, café-au-lait macules or induration. Systemic examination was Inhibitors,research,lifescience,medical unremarkable (JNK inhibitor price Figure 1). Figure 1 Skin-colored plaques with cerebriform surface, comedo-like plugs and nodule seen on the right gluteal region. Routine investigations such as hemogram, blood biochemistry that included a serum lipid profile and urine analysis were within normal limits, as

follows: Hb (12.5 gm%), total leucocyte count (7800/cumm), neutrophils (72%), lymphocytes (28%), and platelet count (2.5 lakhs/cumm). Urine analysis revealed no glucose, ketone Inhibitors,research,lifescience,medical bodies, protein, or blood with a microscopy of 0-2 epithelial cells, no pus cells and no casts. Serum lipid profile results included: serum cholesterol (164 mg/dl), serum triglycerides (110 mg/dl), HDL cholesterol (92 mg/dl), and LDL cholesterol (100 mg/dl). No oral or topical medications were prescribed Inhibitors,research,lifescience,medical for the patient. Staged excision was performed until the lesion was completely removed. Hematoxylin and eosin (H&E) stained sections of the lesion revealed slight hyperkeratosis, papillomatosis and elongation of rete ridges of the epidermis. Ectopic adipocytes were embedded within the collagen bundles in the dermis with no connection of these adipocytes with the subcutaneous fat. The adipose tissues were not encapsulated and were mature. Inhibitors,research,lifescience,medical Dermal adnexa were reduced. According to the histological findings, a diagnosis of NLCSof the right gluteal region was made. No recurrence Inhibitors,research,lifescience,medical was observed in the six-month follow-up (figures 2 and ​and33). Figure 2 Photomicrograph of

epidermal hyperkeratosis, papillomatosis, and elongation of rete ridges with mature adipose tissue in the dermis (H&E, 4×). Figure 3 Photomicrograph Carnitine palmitoyltransferase II showing adipose tissue embedded in the dermal collagen (H&E, 10×). Discussion In 1921, NLCS was first described by Hoffmann and Zurhelle. It is a developmental anomaly that may be present at birth or may even begin in infancy (nevus angiolipomatosus of Howell). If the disorder begins during infancy, the change of hypoplastic dermis leads to pseudotumor yellow protrusions concurrent with skeletal and other malformations. These are usually seen during the first two decades of life, after which they become infrequent.6,7In the current case NLCS was present since birth. Clinically, there are two types: classical (multiple) type and solitary.1,4,5,8 The classical type occurs at birth and is seen frequently in the pelvic girdle, buttocks, lower back or upper thighs.