Clinical Challenge: Asymptomatic Filiform Plaque on the Scalp – MPR

Nevus sebaceous (also known as nevus sebaceous of Jadassohn) is a benign hamartoma that most commonly presents as a waxy yellow- to orange-colored patch or plaque on the scalp or face. Lesions are present at birth or arise in early childhood. The nevus develops a verrucoid appearance over time and remains devoid of hair. The condition usually is not associated with other findings; a rare variant known as linear nevus sebaceous syndrome is accompanied by seizures and ophthalmologic and skeletal changes.1

A variety of tumors that first become evident after puberty may arise from nevus sebaceous.2 Among the most common are syringocystadenoma papilliferum, trichoblastoma, and basal cell carcinoma.3  Treatment involves either observation or excision, the latter performed primarily for cosmesis given that the risk for malignant transformation is low.4,5  Alternative therapies such as laser ablation and dermabrasion are discouraged as these procedures do not completely eliminate the lesion.6

Stephen Schleicher, MD, is director of the

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