NEVUS SEBACEOUS

By Gary M. White, MD

Nevus sebaceous with a basal cell carcinoma
Nevus sebaceous with basal cell carcinoma. Courtesy Michael O Murphy, MD


The nevus sebaceous (NS) is a congenital hamartoma of sebaceous glands found most commonly on the scalp and face.

Clinical

At birth, an orange, red, or yellow plaque is seen, usually on the scalp. Some lesions are linear. Over the ensuing months, with the reduction of maternal hormones, the lesion tends to flatten out. During puberty, under the influence of circulating hormones, the nevus sebaceous will typically thicken again and may resemble a mulberry.

Syndromes

Rarely, a widespread form is seen and is analogous to an epidermal nevus. See nevus sebaceous, systemitized.

SCALP Syndrome. Sebaceous nevus syndrome, central nervous system malformations, aplasia cutis congenita, limbal dermoid, and pigmented nevus syndrome. [Pediatr Dermatol. 2012 May-Jun;29(3):365-7.]

Phakomatosis pigmentovascularis

Treatment

There are two very appropriate treatment options:

  1. Watch and wait
  2. Surgical excision

A discussion with the patient (and parents) is in order, describing the natural history and risks, and then let them decide. Delaying surgical removal until adolescence is a common practice. Sometimes, excision is done for cosmesis.

Photodynamic therapy has been done [AD 1999;135;637].

Additional Photos

Nevus sebaceous on the shoulder of a 22-year-old patient that grew a warty bump. The entire lesion was excised and showed nevus sebaceous with seborrheic keratosis.
Nevus sebaceous Nevus sebaceous

Nevus sebaceous Nevus sebaceous

Nevus sebaceous in the scalp.
Nevus sebaceous Nevus sebaceous

Nevus sebaceous Nevus sebaceous

References

Hidradenoma arising in a NS Dermatology Online Journal 2016;22(1)

Pigmented trichoblastoma in a nevus sebaceous. Dermatology Online Journal 20(7)

Syringocystadenoma papilliferum arising in a NS. JAAD October 2009 Volume 61, Issue 4, Pages 549–560

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