Nevus Sebaceus in puberty: Case series and literature review

Abstract

Background: The sebaceous nevus is a hamartoma, with a combination of abnormalities of the epidermis, hair follicles, sebaceous and apocrine glands, of unknown etiology and with the same incidence in both sexes. It usually occurs at birth, located mainly on the scalp and face, and seen as an alopecic, yelloworange plaque, of variable size and shape. The clinical and histopathological appearance typically changes with age, being maximum at puberty, due to hormonal influence. It may be associated with extracutaneous manifestations, such as involvement of the central nervous system, eyes, skeletal system, and kidneys, constituting the sebaceous nevus syndrome. Benign and malignant secondary tumors originating over the sebaceous nevus are mainly benign and must be confirmed with histopathological study. Full-thickness surgical excision is the treatment of choice, but there is controversy about prophylactic excision, and the optimal age to perform it. Case series description: 4 pediatric patients are presented, treated in the Dermatology Service of the Hospital Escuela, with localized lesions on the scalp and face. Three cases were congenital, as warty alopecic plaques, with rapid growth during puberty; the fourth case presented right supraciliary verrucous lesion at 14 years old. In all, the histopathological study confirmed the diagnosis. Conclusions: Usually sebaceous nevi are congenital and only present skin involvement. Its course is rapid growth at puberty, due to hormonal influence, and the neoformations on the nevus are rarely malignant. We suggest the surgical removal of sebaceous nevus with cosmetic affection and without extracutaneous manifestations before puberty.