NEVUS SEBACEOUS - TO TREAT OR NOT TO TREAT ?

THAT IS THE QUESTION

presented by David Elpern MD (1) and Jag Bhawan MD (2)

(1) Williamstown, MA, USA

(2) Boston, MA, USA

on April 26, 2004

(1) Dermatologist, The Skin Clinic, Williamstown, MA, USA

(2) Professor of Dermatology and Pathology, Boston University School of Medicine, Boston, Massachusetts, USA

References

  1. Cribier B, Scrivener Y, Grosshans E. Tumors arising in nevus sebaceus: A study of 596 cases J Am Acad Dermatol. 2000 Feb;42(2 Pt 1):263-8. The rate of malignant tumors arising on NS was very low and we did not observe such cases in children, who had associated benign tumors in only 1.7% of cases. Benign neoplasms were common and most of them occurred on the scalp; this was not a bias resulting from a longer
    duration before surgery. Trichoblastoma and not basal cell carcinoma was the most frequent follicular tumor associated with NS and showed a striking female predominance. Most trichoblastomas had previously been misdiagnosed but could actually be easily recognized by typical histologic features. Because most tumors occurred in adults older than 40 years, our study suggests that prophylactic surgery in young children is of uncertain benefit. Clinical follow-up is probably sufficient, and even those cases with clinical changes often proved to be benign tumors or warts.
  2. Santibanez-Gallerani A, Marshall D, Duarte AM, Melnick SJ, Thaller S. Should nevus sebaceus of Jadassohn in children be excised? A study of 757 cases, and literature review. J Craniofac Surg. 2003 Sep;14(5):658-60. The incidence of basal cell carcinoma and the need for prophylactic excision in children with nevus sebaceus of Jadassohn have been a topic of controversy. The authors performed a retrospective analysis of 757 cases from 1996 to 2002 in children aged 16 years or younger. No cases of basal cell cancer were found in the nevus sebaceus group. Recent studies in children corroborate these findings and question the need for prophylactic surgical removal of the nevus sebaceus.