Management of Nevus Sebaceous and the Risk of Basal Cell Carcinoma: An 18‐Year Review

Rosen, Heather; Schmidt, Birgitta; Lam, Herman P.; Meara, John G.; Labow, Brian I.

doi:10.1111/j.1525-1470.2009.00939.x

Cited by 79 publications

(99 citation statements)

References 18 publications

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“…cases due to the risk of malignant transformation, but newer studies have shown that the rate of malignancy was grossly overestimated and have drawn confl icting conclusions. Some authors have concluded that observation only is acceptable and excisional biopsy is not necessary, while others still propose prophylactic excision, with disagreements on the timing of treatment (5,(13)(14)(15). If treatment is desired, defi nitive removal of the lesion requires full-thickness surgical excision (14).…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have concluded that observation only is acceptable and excisional biopsy is not necessary, while others still propose prophylactic excision, with disagreements on the timing of treatment (5,(13)(14)(15). If treatment is desired, defi nitive removal of the lesion requires full-thickness surgical excision (14). Th is may be preferred by some patients or parents for cosmetic outcomes or may be indicated due to clinical signs of malignancy such as rapid growth, ulceration, or bleeding (12).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation and Management of an Unusual Congenital Nevus

Kerwin

Menter

2017

Baylor University Medical Center Proceedings

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Abnormal findings on routine skin exams are common and can be a source of unnecessary medical workup if a clinician is unfamiliar with the finding. Sebaceous nevi are rare skin lesions that are most often benign but may be associated with a multiorgan syndrome or local skin cancer. Dermatologists and primary care physicians may encounter these on routine exams and thus must be comfortable with diagnosis and management. We present the clinical characteristics of a benign sebaceous nevus to help aid in diagnosis of these lesions and outline suggestions for appropriate management options.T he total body skin examination is one of the most common dermatologic visits and a common component of primary care visits. Examining the skin for potential malignancies can be taxing; therefore, effi cient evaluation is a necessity for high-volume clinics. Quick identifi cation of malignant features and confi dence in evaluating rare nevi is fundamental to effi ciency. We present a case describing the evaluation and management of a rare, unusual-appearing congenital nevus with neoplastic potential. CASE DESCRIPTIONA 52-year-old white woman presented to the dermatology clinic for a routine annual full-body skin exam and evaluation of a suspicious lesion she noticed on her posterior auricular skinfold. She was unsure how long the lesion had been present but believed it to be growing in size over the past 5 years. She denied pain, pruritus, bleeding, or drainage from the lesion and denied ophthalmologic defects, neurologic symptoms, skeletal deformities, or a personal history of skin cancers.Th e postauricular lesion was a linear, waxy, fl esh-and yellowcolored plaque that measured approximately 40 mm in length (Figure). No erythema or drainage was noted. On palpation, the lesion was fi rm and nonmobile, and sebum could not be expressed. No punctum was identifi ed. No other similar lesions were found on the remainder of the skin exam, only benign nevi and seborrheic keratoses.Th e lesion was determined to be a single sebaceous nevus based on texture, anatomic distribution, physical characteristics, and presence for more than 5 years. A biopsy was not performed as the lesion was not felt to have any signifi cant characteristics suggesting malignancy. Th e patient was counseled to observe the lesion for continued growth, change in texture, ulceration, or pruritus. Th e lesion was photographed to assist with monitoring it over time, with plans for yearly follow-ups. DISCUSSIONSebaceous glands are sebum-secreting glands located in the dermis of all hair-bearing skin and are associated with hair follicles and apocrine ducts (1). Hormones strongly aff ect the activity level of these glands; thus, at the time of puberty, sebum production increases. However, as an individual ages further, sebaceous glands become diff usely hyperplastic, sebum production decreases, and cell turnover and migration slow (2).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation and Management of an Unusual Congenital Nevus

Kerwin

Menter

2017

Baylor University Medical Center Proceedings

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“…NS are often found on the scalp and, unsurprisingly, tumors arising from within NS occur more frequently on the scalp. 6 The most common tumor types that are found to arise within NS are benign; more specifically, between 90% and 97.5% of tumors developing within NS are benign. 2,3 Trichoblastoma and syringocystadenoma are the most common neoplasms that occur in NS.…”

Section: Bmentioning

confidence: 99%

Coexisting Basal Cell Carcinoma and Squamous Cell Carcinoma in Congenital Nevus Sebaceous

et al. 2018

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Nevus sebaceous (NS) is a congenital epidermal hamartoma that is present in less than 1% of newborns.1 NS appears classically on the face or scalp as a waxy, yellow-or orange-colored linear or round plaque. Lesions can involve the epidermis, hair follicle, sebaceous glands, and apocrine glands. NS frequently increases in size during puberty.2 As patients age, there is an increasing risk for the development of cutaneous neoplasms within NS. 3 The vast majority of NS-associated neoplasms are benign. Malignant neoplasms, most notably basal cell carcinoma (BCC), represent less than 1% of the cutaneous neoplasms arising from NS, and frequently affect those over the age of twenty. 3,4 We report the fourth case to our knowledge of BCC and SCC arising concurrently in the same NS.A 56-year-old Hispanic female with no significant medical history presented to clinic regarding a lesion on her left cheek (Figure 1). The lesion had been present since birth but had begun to grow over the last several months. The patient also noted mild discomfort at the site of the lesion beginning around the same time that the lesion started to grow. Family history was negative for any skin cancers or other malignancies.On examination there was a well-defined 1.4-cm x 0.8-cm pink, translucent, pearly ovoid plaque with arborizing telangiectasias overlying the mandible on the left cheek. Two biopsies were taken from the lesion edges and were sent for pathological examination. The first biopsy specimen ABSTRACTNevus sebaceous is a congenital epidermal hamartoma characterized by hyperplastic changes to the epidermis and adnexa. Nevus sebaceous is associated with an elevated risk of cutaneous neoplasms, most often benign; however, malignant neoplasms, most notably basal cell carcinoma, can also present in these patients. Although a rare occurrence more often affecting adult patients, squamous cell carcinomas have also been reported to arise at the site of pre-existing nevus sebaceous. Herein we report a unique case of a patient with basal cell carcinoma and squamous cell carcinoma arising concurrently in the same nevus sebaceous.

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“…16,17 Nevüs sebaseus da nadir de olsa predispozisyon yaratan diğer bir nedendir. 18 Meksika'da yapılan bir araştırmanın sonucuna göre BCC pediatrik yaş grubunda tüm tü-mörlerin %0,24'ünü ve deri tümörlerinin %13'ünü oluşturmaktadır.…”

Section: Bazal Hücreli̇ Karsi̇nomunclassified