What are the other Names for this Condition? (Also known as/Synonyms)

• Jadassohn's Disease II
• Organoid Nevus
• Verrucous Epidermal Naevus

What is Nevus Sebaceous? (Definition/Background Information)

• Nevus Sebaceous (or Sebaceous Naevus) is a congenital malformation that occurs as a 1-2 cm plaque. It is also known as Organoid Nevus
• It is a benign condition that is commonly present on the scalp as a hairless patch. Nevus Sebaceous may grow in size as a child grows and in about 1 in 10 cases, a malignant transformation is observed
• The cause of the condition is unknown, but genetic mutations may be involved. A familial pattern has been seen in some cases
• Complete surgical removal of this benign skin condition can result in a cure. Nevus Sebaceous is usually removed to decrease the chance of a cancerous transformation of the lesion (typically to basal cell carcinoma)
• The prognosis of Nevus Sebaceous is generally excellent with treatment, as long as no malignant transformation takes place

Who gets Nevus Sebaceous? (Age and Sex Distribution)

• Nevus Sebaceous is an uncommon skin condition that is present at birth or may develop at any age in an individual
• Sometimes, the skin abnormality may be very small and not noticed at birth. When the child grows, it may become large and come to attention during adolescence
• Both males and females are affected and there is no gender bias observed
• All racial and ethnic groups are at risk; Nevus Sebaceous is a non-cancerous cutaneous condition that occurs worldwide

What are the Risk Factors for Nevus Sebaceous? (Predisposing Factors)

The risk factors identified for Nevus Sebaceous include:

• Family history of the condition
• Hormonal changes during pregnancy (in the mother) or during puberty in the child is known to influence the growth and development of Sebaceous Nevi

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Nevus Sebaceous? (Etiology)

The cause of formation of Nevus Sebaceous is unknown in a majority of cases.

• The condition occurs due to the malformation of sebaceous glands at or during birth
• In some cases, certain gene mutations have been documented
• Most cases occur sporadically, meaning in a random fashion (sporadic, non-familial condition). However, it can run in families too (familial condition)

What are the Signs and Symptoms of Nevus Sebaceous?

In most cases, Nevus Sebaceous is present as a congenital malformation on the scalp of the child (like a birthmark). It may also develop during early childhood. The lesion is typically solitary and small at birth. Due to hormonal changes during puberty, the lesion may grow and come into prominence (at adolescence).

The signs and symptoms of Nevus Sebaceous that may be observed include:

• It is observed as 1-2 cm plaque. Plaques are broad, raised areas on the skin; they are usually broader than they are high
• Some may even grow to be up to 10 cm in size
• The skin over the surface of the lesion is irregular; no hair is present on the lesion
• Sebaceous Nevi are frequently brown-orange in color
• It is mostly found on the scalp, but may occur on the face
• Occasionally, multiple lesions are present

How is Nevus Sebaceous Diagnosed?

A Nevus Sebaceous is diagnosed through the following tools:

• Complete physical examination with evaluation of medical history: A whole body physical exam has to be performed, since some lesions may not be in direct visible sight
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Serial photographs can help one record a changing skin condition over time
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Note: A skin biopsy is essentially performed to evaluate for any cancerous or malignant transformation. In many cases, a biopsy is not required; the diagnosis is made on a clinical basis only.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Nevus Sebaceous?

The complications that may arise from a Nevus Sebaceous may include:

• Malignant transformation of Nevus Sebaceous (usually to basal cell carcinoma or sebaceous carcinoma), which is thought to occur in over 10% of the cases. The malignant transformation before adulthood is extremely rare. Most lesions are watched clinically during childhood and adolescence. The rate of 10% of Nevus Sebaceous lesions developing basal cell carcinoma is considered high by many dermatologists
• Other benign changes are noted within Nevus Sebaceous. Small benign papillomas occur such as wart-like local projections. Also, larger benign growths (syringocystadenoma papilliferum) occur within the Nevus Sebaceous
• Large lesions or multiple lesions are known to be associated with other health conditions or syndromes
• In some individuals, it may give rise to cosmetic concerns
• Scratching or itching of the lesion may lead to bleeding and ulceration. This can cause secondary bacterial or fungal infections to develop

How is Nevus Sebaceous Treated?

The treatment measures for Nevus Sebaceous may include:

• Surgical excision and removal of the lesion: A complete excision can result in a cure and is usually performed to reduce the risk of malignancy (such as basal cell carcinoma) in adulthood
• Non-surgical methods using photodynamic therapy has been helpful in some cases
• Proper follow-up care with regular screening and check-ups are important

How can Nevus Sebaceous be Prevented?

Current medical research has not established a method of preventing Nevus Sebaceous. However, the following measures can help with early detection of malignant transformation:

• Perform whole body self-examination of the skin, once a month (especially if you are at risk)
• Get a professional skin exam from a healthcare provider, once a year
• Also, undergo skin examinations regularly even after treatment, at least once a year (throughout one’s life)

What is the Prognosis of Nevus Sebaceous? (Outcomes/Resolutions)

• The prognosis of Nevus Sebaceous is excellent on its complete excision and removal
• However, if it turns into a cancerous tumor, then the prognosis mostly depends upon the stage of the tumor and health status of the individual

Additional and Relevant Useful Information for Nevus Sebaceous:

• Do not pick or scratch the lesion
• There is no definitive proof that consuming certain foods influence its development