PatientPlus articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use, so you may find the language more technical than the condition leaflets.
Synonyms: naevus sebaceous, naevus sebaceous of Jadassohn, Jadassohn's disease II, verrucous epidermal naevi (closely related and probably a variant manifestation of the same entity)
This is a well-demarcated hamartomatous lesion composed mainly of sebaceous glands. They are very closely related to verrucous epidermal naevi and many authors consider them to be variant manifestations of the same pathological entity. The most commonly affected area is the scalp, where there is an area of hair loss circumscribing a tan or yellow-orange plaque which is often described as waxy or velvety in texture. They may also develop a warty appearance. Other areas that may be affected less frequently include around the ears, on the face, the neck, trunk or, rarely, in the oral mucosa.
They are usually quiescent lesions but they have a 20-30% risk of developing benign tumours within them,. Malignant change can occur, albeit rarely, in adolescence or adulthood and and even more rarely in childhood.
The most frequent benign tumour to arise in sebaceous naevi is trichoblastoma. The most frequent malignant tumours are basal cell carcinoma and squamous cell carcinoma. A wide variety of benign and malignant tumours may arise from them and there are reports of several different tumour types arising within one lesion in individual patients.
- Usually, a single hairless patch (round or linear) is noted on the scalp at birth, or shortly thereafter.
- The classical velvety tan or yellow-orange appearance may be noted.
- The lesion may appear more prominent in newborns due to the effects of maternal sex hormones.
- In adolescents the lesion tends to take on its nodular verrucoid appearance due to the influence of sex hormones.
- In later life there may be overgrowth of components of the lesion indicating possible benign or malignant tumours developing within the lesion.
Naevus sebaceous under digital microscope
By Jdivis (own work) [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons.
By Phrontis (Own work) [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
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The appearance of sebaceous naevi is fairly characteristic but the following lesions may have a similar appearance or affect similar areas of the body:
- Aplasia cutis congenita
- Naevus syringocystadenomatosus papilliferous
- Juvenile xanthogranulomata
- Solitary mastocytoma
- Other causes of alopecia
Biopsy may be considered for diagnostic purposes or to investigate the nature of tumours that arise within them. Dermoscopy is increasingly being deployed as a non-invasive alternative.
Sebaceous naevi may be associated, in a minority of cases, with an epidermal naevus syndrome (Jadassohn naevus phacomatosis), of which there are several variants. There are extensive sebaceous naevi associated with disorders affecting the central nervous system, bones and the eye. Problems that arise include:
- General learning disability
- Neurological deficits
- Vitamin D-resistant rickets
- Spina bifida
- Hyperplastic bone growth
- Optic nerve defects
- Occulomotor dysfunction
- Some advocate the use of phototherapy with topical aminolaevulinic acid to allow ablation of the lesion in selected cases.
- Due to the difficulty of quantifying the risk of malignant transformation, some specialists advocate full-thickness skin excision before adolescence. Others recommend watchful waiting.
- Some cases will in any case not be suitable for excision due to their size and location. These should be subjected to regular review.
- Seek the advice of a dermatologist and/or plastic surgeon to help decide on the need for, and timing of, excision.
- Any lesion that changes its appearance significantly, ulcerates, becomes painful, bleeds or shows other signs of potential malignancy should be referred to a dermatologist.
- Poor cosmetic appearance.
- Development of a benign or malignant tumour within the lesion.
- Complications associated with removal of the lesion.
Further reading & references
- Sakanoue M, Matsushita S, Kawai K, et al; Microcystic adnexal carcinoma arising in a nevus sebaceous. Indian J Dermatol. 2013 May;58(3):247. doi: 10.4103/0019-5154.110903.
- West C, Narahari S, Kwatra S, et al; Autosomal dominant transmission of nevus sebaceous of Jadassohn. Dermatol Online J. 2012 Nov 15;18(11):17.
- Cifuentes L, Ziai M; Images in clinical medicine. Nevus sebaceous. N Engl J Med. 2012 May 17;366(20):1923. doi: 10.1056/NEJMicm1111099.
- Nevus Sebaceous of Jadassohn, DermIS (Dermatology Information System)
- Sebaceous naevus, DermNet NZ, 2013
- Enei ML, Paschoal FM, Valdes G, et al; Basal cell carcinoma appearing in a facial nevus sebaceous of Jadassohn: dermoscopic features. An Bras Dermatol. 2012 Jul-Aug;87(4):640-2.
- Rosen H, Schmidt B, Lam HP, et al; Management of nevus sebaceous and the risk of Basal cell carcinoma: an 18-year review. Pediatr Dermatol. 2009 Nov-Dec;26(6):676-81. doi: 10.1111/j.1525-1470.2009.00939.x. Epub 2009 Jul 20.
- Premalata CS, Kumar RV, Malathi M, et al; Cutaneous leiomyosarcoma, trichoblastoma, and syringocystadenoma papilliferum arising from nevus sebaceus. Int J Dermatol. 2007 Mar;46(3):306-8.
- Nevus sebaceus of Jadassohn; Online Derm Clinic, 2013
- Hassan I; Sebaceous naevus located in the nasal cavity, Our Dermatol Online. 2012; 3(1): 33-35.
- Laura FS; Epidermal nevus syndrome. Handb Clin Neurol. 2013;111:349-68. doi: 10.1016/B978-0-444-52891-9.00041-5.
- Babilas P et al; Photodynamic therapy in dermatology, European Journal of Dermatology. Volume 16, Number 4, 340-8, July-August 2006, Review article
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Sean Kavanagh
Dr Laurence Knott
Prof Cathy Jackson