Sebaceous Nevus of Jadassohn
HISTORY
21-year-old male presents with 10-year history of left cheek lesion that has become more prominent with puberty and thickened over time. An excision found sebaceous nevus of Jadassohn.
![sebaceous-nevus-of-jadassohn-orange-county-skin-cancer](https://scarscenter.com/wp-content/uploads/2018/09/sebaceous-nevus-of-jadassohn-orange-county-skin-cancer-1.png)
Fig. 1. Nevus sebaceous of the left cheek.
![sebaceous-nevus-of-jadassohn-orange-county-skin-cancer-cheek](https://scarscenter.com/wp-content/uploads/2018/09/sebaceous-nevus-of-jadassohn-orange-county-skin-cancer-cheek.png)
Fig. 2. Immediately after excision of the cheek lesion.
DISCUSSION – Nevus Sebaceous
These congenital skin lesions are often excised. Timing and rationale of excision are based on the science behind the nevus sebaceous.
- Congenital epidermal hamartoma
- Responds to hormonal influences
- From hypoplastic before puberty to hyperkeratosis and papillomatosis with numerous and hyperplastic sebaceous glands after puberty
- clinically the lesion thickens with age
- Most commonly presents in the head and neck – 95%
- Neoplastic transformation occurs uncommonly
- Most common tumors arising within are benign
- syringocystadenoma papilliferum
- trichoblastoma (may be misdiagnosed as Basal Cell Carcinoma)
- BCC is the most common malignant transformation (deletions of patched gene)
- SCC, adnexal carcinomas, malignant melanomas have been reported
- 5-20% lifetime risk of malignant degeneration (higher incidence studies had trichoblastomas misdiagnosed as BCC?)
- 0.8% of excised sebaceous nevi in adolescents had BCC in one study (misdiagnosed trichoblastomas?)
- Long duration associated with malignant change
- Most common tumors arising within are benign
- Consider excision after puberty
- When large or with Epidermal Nevus Syndrome (Jadassohn Nevus Phakomatosis)
- CNS problems – Developmental delay, seizures, intracranial mass
- Bone problems – bone hypertrophy, spina bifida
- Eye problems – optic nerve hypoplasia, oculomotor dysfunction
![sebaceous-nevus-of-jadassohn-orange-county-skin-cancer-histomicrograph](https://scarscenter.com/wp-content/uploads/2018/09/sebaceous-nevus-of-jadassohn-orange-county-skin-cancer-histomicrograph1.png)
Fig. 3. Histomicrographs of nevus sebaceous.