By Gary M. White, MD
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.
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.
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.]
There are two very appropriate treatment options:
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].
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 in the scalp.
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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