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Nevo Sebaceo
Nevo Sebaceo
Nevo Sebaceo
1 1523, 2012
Abstract: Nevus sebaceous of Jadassohn is a hamartoma with a combination of abnormalities of the epidermis, hair follicles, and sebaceous and
apocrine glands. Herein, we discuss the results of an extensive literature
review on the topic of nevus sebaceous with a particular focus on the debate
about the necessity for prophylactic excision. We also focus on the documentation of associated malignant tumors that were reported to develop
within NS. In addition to reporting the number and types of neoplasms, we
documented the recommendations of all authors for therapeutic handling of
these nevi.
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Figure 1. The specimen consists of an excision of epidermis, dermis, and subcutaneous fat. Epithelial hyperplasia is
associated with poorly formed hair follicles and prominent, but
mature, sebaceous glands. Apocrine glands are seen
focally. The features are those of an organoid nevus. 4
magnification.
measuring
17
Year of
publication
Patients, n
Mehregan (8)
1965
150
15
19
1968
1969
1970
40
160
140
28
39
5
21
9
Domingo* (13)
1979
997
10
1985
29
NA
10
Morioka (22)
1985
80
51
18
Smolin (12)
1986
181
12
Weng (43)
1990
62
32
19
1991
1995
1998
5
7
13
0
5
Beer (26)
1999
18
22
Cribier (9)
2000
596
13
Jaqueti (3)
Kaddu (16)
Munoz-Perez (17)
Santibanez-Gallerani (18)
Taklif (50)
2000
2000
2002
2003
2004
155
316
226
658
42
36
7
18
<2
5
0
1
4
0
10
Simi (51)
Rosen (19)
Average
2008
2009
21
631 (651 NS)
234 NS
Benign, %
40
175 (225 NS)
136
Malignant, %
10
2
16 (Range 051)
5
1
8 (Range 022)
Type of malignant
neoplasm (n)
BCC (21)
KA (4)
Sebaceous ep (4)
BCC (2)
BCC (34)
BCE (9)
SCE (1)
Sebaceous epithelioma (ep) (1)
KA (2)
Adnexal carcinoma (3)
Apocrine carcinoma (4)
SCC (1) SCC adnexal (1)
BCC (2)
Leiomyoma (1)
BCE (10)
Apocrine ep (1)
Sebaceous ep (3)
BCC (21)
Prickle cell carcinoma (1)
BCC (6)
Sebaceous ep (6)
BCC (5)
BCE (4),
Sebaceous carcinoma (3)
BCC (3)
BCC KA (1)
BCC (5)
KA (4)
BCC (2)
BCC (8)
BCC (3)
Inverted KA (1)
SCC (1)
BCC (5)
*Excluded basal cell carcinoma (BCC) (not stated how many excluded).
KA, keratoacanthoma; BCE, basal cell epithelioma; SCC, squamous cell carcinoma.
Reported, n
In children, n (%)
References
BCC*
SCC
KA
Melanoma
Porocarcinoma
Adnexal carcinoma or adenocarcinoma
Apocrine carcinoma
Sebaceous carcinoma
Leiomyosarcoma or piloleiomyoma
Multiple malignancies
(SCC adnexal carcinoma, BCC sebaceous
carcinoma, BCC SCC, BCC KA)
119
15
14
1
1
5
7
33
3
6
14 (12)
7 (47)
3 (21)
0
0
0
0
0
0
0
(8,9,11,12,1517,19,2230,42,43,4850,5262)
(1,11,13,3133,51,6367)
(8,9,11,3436,50)
(68)
(69)
(13,21,70)
(13,7173)
(8,15,43,71,7479)
(48,80,81)
(2,13,20,26,82,83)
*Some authors have be questioned whether the BCC were trichoblastomas (3,9).
SCC, squamous cell carcinoma; KA, keratoacanthoma
19
Year
published
Mehregan (8)
1965
Lillis (42)
1979
Alper (84)
1983
Weng (43)
1990
Buescher (34)
Chun (14)
1991
1995
Hughes (25)
Stavrianeas (60)
1995
1997
Beer (26)
Jaqueti (3)
1999
2000
Cribier (9)
2000
Kaddu (16)
2000
Santibanez-Gallerani (18)
Taklif (50)
2003
2004
Rosen (19)
2009
Year
published
Patients, n
(Location)
Excision or reconstruction
recommended
Mehregan (8)
1965
150
Necessary to do a full-thickness
excision and can excise large nevi
in several stages without skin grafts
Lillis (42)
1979
Weng (43)
1990
62
Ashino (44)
1993
Hughes (25)
1999
18
Davison (7)
2005
13 (temporal
scalp)
Donelan (41)
2008
In (45)
2010
12 (face)
Kim (46)
2010
1 (face)
1 (scalp)
Specics
Presence of apocrine glands requires
full-thickness excision
To remove in stages, a longitudinal
strip is removed, the skin is sutured,
and the scalp is given time to stretch
before another strip is removed
Incomplete removal could lead to
recurrence
Does not recommend electrocautery,
fulguration, or supercial destruction of
the lesion because they may provoke
cellular transformation or mask
potentially malignant changes in NS
Greatly improves cosmetic appearance
but does not remove the entire lesion
(only that part in the epidermis and
papillary dermis)
Do not treat using dermabrasion or
dermablation, because they may miss
epithelialization and leave malformed
parts of NS, because the treatments
remove only the part of the lesion in the
epidermis and upper dermis
Excellent blood supply of the supercial
temporal artery system
Preserves hair on scalp
Cosmetically good results
Minimizes extension into forehead skin
Two expansions
No lasting alopecia
25% had 2550% improvement
58% had 5075% improvement
17% had >75% improvement
Transient improvement
CO2, carbon dioxide; MAL, methylaminolevulinate; PDT, photodynamic therapy; Er:YAG, erbium-doped yttrium aluminum garnet.
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