nevus sebaceous

This birthmark is a strange linear patch of slightly raised, yellowish colored little plaques perhaps 1/2-1 mm in diameter. I seem to see these mainly on the face or scalp. This birthmark has some malignant potential in adult life. However, it is now thought that this potential for malignancy is much less than once believed1 and the old rule of "excise them all" has been supplanted by a conservative approach; regular observation is not required unless the lesions are large.

The lesion itself is an overgrowth of oil (sebaceous) glands with abnormally small or absent hair follicles. As noted above, it can occur on the face or neck, or on the scalp (one of the causes of alopecia or apparent hair loss). In babies, it appears as pebbly orange or yellow lesions. These become thicker and more wart-like later in childhood.

This birthmark can be associated with other health problems, including birth defects affecting the eye, skeleton, heart and urogenital tract, which your doctor should examine for. There is a very rare "nevus sebaceous of Jadassohn syndrome," consisting of a large linear sebaceous nevus, seizures, and mental retardation. For this reason it is generally recommended that children with large sebaceous nevi have a neurological assessment. However, the much more commonly found small sebaceous nevi are not associated with this syndrome and should not be a cause for worry.

1. A 2007 study by Barkham et al concluded that prophylactic excision of all sebaceus nevi is not warranted and excision should be only recommended when benign or malignant neoplasms are clinically suspected or for cosmetic reasons.

Barkham MC, White N, Brundler MA, Richard B, Moss C. Should naevus sebaceus be excised prophylactically? A clinical audit. J Plast Reconstr Aesthet Surg. 2007;60(11):1269-70.

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