Nevus sebaceus: clinical outcome and considerations for prophylactic excision.
OBJECTIVE
Nevus sebaceus is a hamartoma of the skin with the potential to develop benign and malignant neoplasms. Prophylactic surgical excision has been advocated, usually before puberty, to prevent their occurrence; however, it is the clinical impression of the authors that the development of cutaneous neoplasms is infrequent and, if they develop, they are usually benign and nonaggressive. Our objective was to investigate the clinical outcome and histopathologic findings of every single nevus sebaceus that had been excised in our institution in a five-year period.


METHODS
Two hundred and twenty-five consecutive cases, coded as nevus sebaceus corresponding to 175 patients were submitted to our institution between September 1987 and May 1992, and were identified among a total of 64,827 specimens. All cases were reviewed histopathologically and clinical information was obtained from the records. Specimens from 10 patients were excluded.


RESULTS
A total of nine benign neoplasms (5.4%) were identified in the 165 patients. Three patients were in their second decade of life, two in their third, two in the fifth and two in the sixth. There were five trichoblastomas, three specimens of syringocystadenoma papilliferum, and one aprocrine cystadenoma. No malignant neoplasms were found. Six of the tumors were removed either for prophylactic or cosmetic reasons and in only three cases were the neoplasms suspected clinically and excised.


CONCLUSIONS
If this same tendency prevails in other prospective studies, we strongly believe that prophylactic excision of all nevus sebaceus is not warranted. Excision should be recommended only when benign or malignant neoplasms are clinically suspected or for cosmetic considerations.
Chun
K
K
Department of Dermatology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
Vázquez
M
M
Sánchez
J L
JL
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006222:Hamartoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012867:Skin / Q000473:pathology; D012868:Skin Abnormalities; D012878:Skin Neoplasms / Q000150:complications