Nevus of the sebaceous glands in newborns. Nevus of the sebaceous glands: description, appearance with a photo, causes, diagnosis and treatment

Epilepsy and mental retardation, but such cases are very rare. Clinically, this corresponds to the superposition of the linear epidermal nevus syndrome.

Laboratory diagnostics

■ Histological characteristics vary with the age of the patient.

■ In the first few months of life, the sebaceous glands are well developed as a result of stimulation by maternal hormones, although the surrounding hair structures are not fully differentiated.

■ Diagnostic changes occur at puberty. The sebaceous glands mature and increase in size and density. Hair structures remain undifferentiated, papillomatous epidermal dysplasia develops. Ectopic apocrine glands may be located deep in the underlying intradermal layers.

In a later period of life, tumors of the skin appendages may develop within the sebaceous gland nevus. Each of these tumors has its own histological picture. The most common tumor is syringocystoadenoma papilliferum, a benign apocrine tumor that occurs in 20% of lesions.

Basal cell carcinoma is the second most common tumor and the most common malignant tumor that develops within the nevus of the sebaceous glands (in about 7% of foci).

Course and forecast

The sebaceous nevus remains stable throughout childhood and undergoes predictable changes during puberty.

Treatment

Nuances

■ During puberty, there is massive proliferation of the sebaceous glands.

■ The surface of the nevus becomes verrucous or velvety.

■ The sebaceous nevus tends to develop basal cell carcinoma within the nevus after puberty.

■ For some lesions of sebaceous nevus, surgical invasion during infancy is recommended (for example, in the case of large sebaceous nevus).

■ Larger lesions can be excised in parts without worrying about the possible initiation of a malignant process.

■ Large defects on the scalp are easier to correct in infancy.

The sebaceous gland nevus is most often found on the scalp. The lesions can also be found in the neck and trunk.

Hormonal changes during puberty stimulate the growth of the sebaceous glands. For this reason, the velvety-smooth surface becomes verrucous and knobby.

The lesions are found on the scalp, face, behind the ears, on the neck and trunk.

A colleague sent a patient for a consultation, and I had the opportunity to take a rather rare photo - the growth of basal cell carcinoma against the background of Jadasson's nevus.

In principle, such a photograph and such a case would probably be interesting only to specialists, if not for one "but".

Jadasson's nevus is most often a congenital pathology. Benign, but prone to malignancy - in 5-30% of cases (which is a lot), various tumors, including malignant ones, develop in these nevi. Most often - basal cell carcinoma, which is not particularly dangerous, but sometimes more malignant variants.

The patient sent for consultation has lived with this nevus all his life, and the nodular formation appeared ... about 15 years ago. I will not comment on this and, moreover, look for the reason in someone else (the patient did not apply to specialists-dermatologists / oncologists, and doctors of other specialties rarely encounter this type of nevi, and the patients themselves are used to living with it and do not show these nevi to doctors when they turn to them for other reasons), but rather I will describe the nevus itself.

This nevus is a malformation of the sebaceous glands, therefore it is also called a sebaceous nevus. In two thirds of cases it is congenital, in one third of cases it manifests itself in early childhood. Very rarely, this nevus can manifest itself at a later age, in adolescents, but it happens. Sometimes there are familial cases of these nevi.
It arises from the cells of the ectoderm (from which, among other things, our integumentary tissues are formed) due to definitively unexplored mutations, and is hypertrophied sebaceous glands, coupled with other glands and deformed hair follicles. Refers to hamartomas - benign tumors resulting from a violation of the embryonic development of organs and tissues, consisting of the same components as the organ where they are located, but differing in their incorrect location and degree of differentiation.

Outwardly, this nevus is a flat plaque, sometimes oval, sometimes asymmetric, with a granular, warty surface and with a yellowish tinge. Sizes can be different - from half a centimeter to large, 10-centimeter formations. It is located more often on the scalp, but it can also be in other places. The nevus itself is not covered with hair, and its not very aesthetic appearance determines that its owners begin to cover it with hair and not show it to anyone. Including doctors. What a waste.

By itself, the nevus does not cause any unpleasant sensations. With age, this nevus changes - so, in childhood, a nevus is usually represented by a uniform fine-grained plaque of yellow-pink, pink, orange, and in adolescence the elements of the nevus become larger, it becomes more heterogeneous, sometimes sometimes with large warty elements.

Most often, this nevus does not cause any health problems, but, as mentioned above, in 5-30% of cases, various tumors, including malignant ones, can form in it.

This behavior of Jadasson's nevus is the reason that many experts recommend removing it before adolescence. However, this question is not straightforward.
So, researchers from the Miami Children's Clinic from 1996 to 2002 analyzed 757 cases of removal of the Jadasson nevus in children under 16 years old, and in this group there were no cases of basal cell carcinoma, in connection with which the expediency of operations in childhood was questioned. A similar study, with fewer patients, was previously conducted in France.

The feasibility of prophylactic removal in adults is still an open topic. In any case, both children and adults, with the presence of Yadasson's nevus, are shown periodic preventive examinations by an oncologist or dermatologist, so that it does not work out like our patient.

Let's get back to it, however.
When viewed on the patient's scalp, a formation of about 7 cm is determined, clinically interpreted as Jadasson's nevus. On the surface of the nevus, nodular formations with areas of pigmentation are noted. With dermatoscopy in the nodular formations, tree-like vessels are determined, based on a set of signs, a clinical diagnosis: basal cell carcinoma, which arose against the background of Jadasson's nevus.

The patient underwent a biopsy of the formation, histological verification:

The prognosis for life and health is favorable. Local relapses of basal cell carcinoma are possible, but with adequate supervision of the oncologist, which, I hope, will now be performed, the patient is not in danger. The nevus, of course, will be removed completely, but this is quite an easily experienced procedure.

The nevus of the sebaceous glands of Jadasson, or, as it is also called, seborrheic, is a tumor-like neoplasm, primarily due in its nature to the appearance of a malformation of the sebaceous glands, like other elements of the dermis. Most often, seborrheic nevus is congenital, less often acquired, manifesting itself in childhood, infancy. What causes provoke the appearance, and what treatment is indicated, we will consider in this article.

Important to remember! Most often, a sebaceous nevus affects the scalp or face, less often other parts of the body.

Clinic of pathology

Jadasson's nevus most often affects the scalp - it is a nodular neoplasm that occurs due to pathological tissue growth at the stage of embryo development. The neoplasms are solitary, limited in shape and have an oval shape, a linear baldness zone, manifested by a waxy plaque.

According to its clinical manifestations, pathology has the following signs:

Seborrheic nevus goes through several stages in its development:

1. At the first stage, neoplasms appear on the skin of the child - symptoms manifest themselves by the appearance of papillae on the dermis.
2. The second stage most often manifests itself during puberty in the form of globular papules, adjacent closely to one another.
3. The third stage - most often it manifests itself in adolescence in the form of small or large growths protruding above the skin.

It is the third stage that is the most dangerous and, in the absence of treatment, can transform from benign into malignant neoplasm.

At the moment, doctors cannot say unambiguously what provokes the appearance of a nevus of the sebaceous glands, but they identify a number of factors that can lead to the development of this disease.

So, doctors call the following concomitant factors provoking the appearance of a nevus:

Complications of the disease

For the most part, the appearance of a nevus will proceed without characteristic symptoms, and therefore control by a dermatologist is so important in order to avoid negative consequences and complications. Doctors note the fact that in 15% of cases, a benign neoplasm will develop into a cancerous one, less often a benign form of adenoma may develop.

In case of malignant neoplasm, the prognosis is unfavorable and surgical removal is impossible due to the high risks of the spread of cancer cells. In this case, it is exclusively supportive treatment.

With a benign neoplasm, the pathology has favorable prognosis, and the treatment involves surgery. The main thing in this case is timely, early diagnosis and taking the necessary measures, including radical, surgical removal of the neoplasm.

Important! The nevus of the sebaceous glands can also affect nearby tissues, nerve endings, vision and bone tissue, even the central nervous system and the genitourinary system, and in childhood, this can result in mental retardation, the development of epilepsy.

Diagnostics and treatment

First of all, the doctor examines and interviews the patient, collecting anamnesis - when the neoplasm appeared and whether relatives had such pathologies. Based on the initial survey and examination, a preliminary diagnosis is made, after which the patient is sent for laboratory tests.

Laboratory tests will confirm or deny a diagnosis such as dermal cancer or papillary nevus. In particular, the latter is marked by an intense pink color, and the neoplasms themselves have a slightly different structure. Most often, histology is prescribed - it determines the depth and characteristics of the existing neoplasm.

A smear is also taken with the help of a puncture - this will determine the risk of the tumor degenerating into malignant oncology. Based on the results of the analyzes received, doctors prescribe a course of treatment - it can be like constant observation by a dermatologist, but most often it is about more cardinal methods, such as surgical intervention.

Due to the fact that the risks of nevus tissue degeneration into malignant oncology are very high, doctors recommend surgery at the earliest age before the child reaches puberty. The thing is that more gentle methods for removing a nevus, for example, using cryodestruction, can give a positive result, but in the future the pathology will manifest itself again.

In this case, doctors talk about the need for complete removal by excision of the neoplasm within its growth zone and a thin strip of existing healthy tissue.

If it is impossible to remove the neoplasm at a time, doctors carry out several surgical interventions, gradually removing the pathologically overgrown tissues with a minimum period of time. As a result, if the nevus is located on the head or face and is very large in size, then surgery is considered difficult.

Surgical removal of a nevus is carried out in a hospital setting of medical institutions, whose work profile is the treatment of oncological diseases, using local or general anesthesia, depending on the size. After removal of the neoplasm, the resulting material is sent for histology to confirm or refute suspicions of cancer.

Most often, doctors use a conventional scalpel or an electric knife to remove the nevus of the sebaceous glands. If, according to the results of laboratory tests, the sent histology of cells atypical in the body is detected, repeated diagnostics are carried out, monitoring the patient's health and, if necessary, specialized treatment.

Due to the fact that the root causes of the development of a nevus of the sebaceous glands have not yet been established by doctors as such, accordingly there are no preventive measures that can be advised to prevent the development of this pathology.

With the timely detection of a neoplasm and treatment, doctors give the most favorable prognosis. As statistics show, 10% may develop basal cell carcinoma, less often cancer. Accordingly, the earlier the nevus is removed, the lower the risk of developing pathological abnormalities.

A sebaceous gland nevus is a neoplasm that is congenital in 7 out of 10 cases. It manifests itself quickly enough, from the first days you can determine it. In some cases, a nevus can be seen during the first few years of a child's life. The site of localization is most often the head (the edge of the hairline), the face, and very rarely other parts of the body.

general information

Unfortunately, modern medicine still cannot accurately study all the causes of the appearance of a nevus. In most cases, this formation is not considered something dangerous, but if you do not take any measures, then over time, a complication may occur. Below is a photo of a sebaceous gland nevus.

The sebaceous nevus is large, it can reach 6 centimeters in diameter. Its surface is bumpy, painted yellow. In the place where the nevus of the sebaceous glands on the head is located, the hair is absent.

When the baby was just born, and he immediately has this neoplasm, then initially it looks like a small speck, which over time begins to grow. After a while, the stain turns into a small wart. In the vast majority of cases, this unpleasant growth appears on the scalp. Such a neoplasm may also appear on other parts of the body, but much less often.

Stages of education

The sebaceous nevus in children has three stages of formation:

1. The surface of the neoplasm is smooth with small papillae. There is no hairline in this place. The nevus of the sebaceous glands in newborns does not rise above the skin.
2. Teenage years. Small papules are formed on the skin, which outwardly are very similar to warts. They have a yellow or orange tint. Very close to each other.
3. Youth period. At this age, the disease is very dangerous, since there is a high risk that the neoplasm can degenerate into a cancerous tumor. At this stage, the sebaceous nevus should be monitored by a specialist dermatologist.

Why does a nevus appear

Most scientists assume that the main cause of the sebaceous gland nevus is their hyperplasia. Due to the pathological proliferation of tissues, an increased abnormal division of cells of the epidermis, hair follicles and apocrine gland occurs, and due to this, a nevus is formed.

What can cause a nevus to degenerate

To the delight of many people, a nevus rarely brings great harm to a person, but there are still exceptions, and a harmless neoplasm can turn into a malignant tumor. Factors that can provoke such a rebirth:

Epidemiology

The nevus of the sebaceous glands on the face or on the head most often begins to develop in the womb. But it can also occur a little later in childhood or adolescents. The disease is not related to the sex of the child; the disease can appear in both boys and girls. The disease is not often inherited. Most often the disease is congenital, and its development has two stages: infantile and prepubertal - primary school age, and pubertal - adolescence.

Symptoms and course

In most cases, no symptoms appear. Only in a few percent of cases, the neoplasm is accompanied by disorders of the central nervous system or abnormalities in the structure of the body.

The rate of development of a nevus is rather slow, the formation increases minimally in diameter and begins to rise above the skin. In one case in ten, small ulcers and nodules begin to appear. Sebaceous nevi are much more likely to transform into trichoblastomas or syringocystadenomas.

Risk of complications

The nevus of the sebaceous glands degenerates into malignant neoplasms quite rarely. According to statistics, in 15% of all cases, seborrheic nevus disease can degenerate into basal cell carcinoma. Epithelial adenoma (benign formation) develops quite rarely. Sometimes illnesses can be accompanied by ailments such as rhinophyma and blepharitis.

The most dangerous of all these complications is, of course, basal cell carcinoma. This malignant neoplasm begins to develop in people after the age of 40. Very often, various kinds of nevus injuries become a provocateur of rebirth. Therefore, if a person has such an ailment, then he should be treated with extreme caution so as not to damage it in any way. Due to the fact that the nevus is often located on the scalp, it can become traumatized while combing the hair.

Diagnosis of the disease

When a patient visits a medical institution, the doctor first of all draws attention to the patient's age, asks if relatives have had this, and also when the neoplasm appeared. Examining the patient externally, the doctor can only make a preliminary diagnosis.

Laboratory tests will help to more accurately diagnose the disease. With their help, it will be possible to determine whether the disease is a solidary mastocytoma, aplasia of the dermis, or, in the worst case, skin cancer.

Also, histology is performed to make a more accurate diagnosis. With its help, it is possible to more accurately determine the peculiarity of the formation that has appeared on the skin and the depth of the lesion of the epidermis. In order to prevent the development of a cancerous tumor, an analysis is made for atypical cells.

If necessary, the doctor takes a swab from the fluid from the formation. This helps determine the risk of nevus degeneration. But with this method of research, as with histology, tissue injury occurs.

Treatment methods

After the diagnosis is made, the recommendations of the attending physician should be strictly followed. In no case should you self-medicate or try to get rid of a neoplasm yourself, this can have very bad consequences - a nevus can degenerate into a cancerous tumor.

The formation should be removed only in a medical institution and at an age before puberty.

There are three ways to remove a sebaceous nevus:

• surgical removal;
• excision with an electric knife;
• destruction with liquid nitrogen.

As a rule, the removal procedure is carried out in oncology centers under the supervision of an oncologist and dermatologist. A piece of the removed tissue must be sent for histological examination.

If, as a result, atypical cells were found, then a second diagnosis is usually done to detect the presence of metastases in other organs and on the face.

Surgical removal is considered the most effective. With other methods, a sebaceous nevus may reappear.

During surgery, the neoplasm is excised. If it is not possible to remove the nevus in one go, then the damaged skin is removed in stages. Interruptions between operations should be minimal. It often becomes difficult to perform the operation due to the location of the pathology.

Surgical intervention can be performed under local or general anesthesia. The doctor decides which anesthesia to choose. It depends on the age of the patient, as well as on the location and size of the formation. After excision of the nevus, the wound is sutured. If it was large and in a prominent place, a skin graft is done.

A sterile bandage is applied to the seams. Dressings are done every day for a week, while the wound is treated with antiseptic agents. After the wound has healed, the stitches are removed.

Prevention and prognosis

How to make sure that the sebaceous nevus does not appear at all, no one knows. It is better to remove it even in childhood (up to 12 years old) or when the child is still very young. Surgical removal never relapses.

The prognosis is most often favorable. According to statistics, only 10% of patients develop basalioma. Degeneration into a malignant formation occurs even less often.

Nevus is a rather unpleasant disease that can occur on the face, which significantly spoils the appearance of a person. Such changes in the body occur most often in adulthood. If we are talking about atheroma, then it occurs for unknown reasons. Atheroma is a blockage of the sebaceous gland, after which a cyst occurs. It is located under the skin.

The risk that atheroma will turn into oncology increases significantly with age-related changes in a person. We can say that a sebaceous nevus is quite dangerous, because an adenoma of the sebaceous glands develops from it, which is located on the face and scalp. Adenoma of the sebaceous glands grows slowly, but it can corrode the skin, leading to deep defects (scars). Such a neoplasm is benign and can be effectively treated.

Dangerous, there is a process of degeneration of a sebaceous nevus into adenocarcinoma. The disease is actively developing and progressing rapidly. Removal is carried out using a special apparatus (laser), but there is a possibility that the formation will continue to grow.

Many researchers are inclined to believe that absolutely all pigmented nevi, even those that appear with age, are congenital skin malformations. The disorders that lead to the formation of this benign tumor occur even in the embryonic state of the body.

Until now, all the congenital causes of the formation of dysplastic nevi have not yet been studied. The main factors are:

• Fluctuations in the level of sex hormones in a pregnant woman's body: progestins and estrogens.
• Infections of the genitourinary system in pregnant women.
• The impact on the body of a pregnant woman of adverse factors: toxic substances, radiation.
• Genetic disorders.

Under the influence of all these factors, the development of melanoblasts is disrupted - the cells from which melanocytes are subsequently formed. As a result, melanoblasts accumulate in certain areas of the skin and transform into nevocyte cells.

Neocytes differ from normal melanocytes in two ways: 1. They do not have processes along which the pigment could spread to other skin cells; 2. Dysplastic nevi obey the general regulatory systems of the body worse, but, unlike cancer cells, they have not completely lost this ability.

It is believed that new pigmented nevi do not appear with age, but only those that have existed since birth, but were not noticeable, manifest themselves.

The following reasons can initiate the manifestation of new melanocytic nevi:

• Hormonal changes in the body. This is very clearly manifested in adolescence, when most of the nevi appear on the body.
• Action on the skin of ultraviolet rays. Frequent sunbathing and tanning beds promote the growth of age spots.
• Pregnancy. As noted above, this is due to fluctuations in the level of sex hormones in a woman's body.
• Menopause.
• Taking contraceptives.
• Inflammatory and allergic skin diseases (acne, dermatitis, various rashes).

The exact reasons provoking the onset of pathology are unknown. Most scientists are inclined to the theory that hyperplasia of the sebaceous glands is one of the main factors. Against the background of pathological tissue proliferation by enhanced abnormal cell division of hair follicles, epidermis and apocrine gland, a nevus of Jadasson is formed.

Factors causing the degeneration of a sebaceous nevus into a malignant tumor
Factors	Description
Pathological development of cells	The number of cells of the sebaceous gland actively increases, hyperplasia sets in. Plaques can grow together to form large warts.
Genetic predisposition	The disease is transmitted from parents at the genetic level. The presence of the disease in family members increases the risk of nevus malignization.
Chronic diseases	Inflammatory processes in the digestive tract contribute to the degeneration of a sebaceous nevus into a malignant neoplasm.
External factors	The negative effects of toxic substances or radiation, constant exposure to sunlight and thermal burns often precede the pathological degeneration of the nevus.

In 7 out of 10 people who get sick, the sebaceous nevus is congenital. In other cases, the disease develops before the age of 4 years. Boys and girls suffer from the manifestations of pathology equally often.

The main cause of seborrheic nevus is the pathological proliferation of the sebaceous glands on the face, scalp or along the hairline. The factors contributing to the development of pathology have not yet been established.

Symptoms and classification of nevi

Melanocytic nevi have a wide variety of shapes, colors, and sizes. Until now, there is no unequivocal opinion among doctors about which formations should be designated by the word "nevus". Therefore, sometimes benign skin tumors that do not contain the pigment melanin are called nevi:

• Hemangiomas - vascular tumors. Especially common is the concept of "strawberry nevus" - a red hemangioma, which is present in most newborns, and disappears during the first year of life. Also, many doctors operate with such a concept as a vascular nevus.
• Sebaceous gland nevi - in most cases located on the head, also do not contain melanin. This growth is known as a sebaceous nevus.
• Sometimes congenital nevi in \u200b\u200bchildren is also called teratomas (hamartomas), which, in fact, are congenital tumors, consisting not only of the skin, but also of all other tissues.
• Anemic nevus - a kind of vascular nevus. This is an area of \u200b\u200bthe skin where the vessels are underdeveloped, so it has a lighter color.

A true melaniform nevus is a formation that occurs from altered melanocyte cells - nevocytes.

There are the following types of nevi: 1. A non-cellular borderline nevus is a simple spot that does not rise on the skin, or slightly protrudes above its surface. Border nevus has clear outlines and brown coloration. It can be of different sizes and located on different parts of the body. With this type of melaniform nevus, the accumulation of cells with pigment is located between the upper (epidermis) and middle (dermis) layers of the skin - this arrangement is referred to as an intraepidermal nevus. 2.

Intradermal nevus is the most common type of melaniform nevus. It is so called because the accumulation of pigment cells is located in the thickness of the middle layer of the skin - the dermis. 3. Pigmented complex nevus of the skin. Such a nevus looks like a mole: it rises on the skin and can have a different color, from light brown to almost black.

Often coarse hair grows on it. A mixed nevus has a smooth surface and can be found on any part of the body. 4. Intradermal nevus. It also protrudes above the surface of the skin, but, unlike a complex nevus, it has an uneven, bumpy surface. Almost always located on the head or neck, very rarely on the body.

In most cases, an intraepidermal nevus appears between the ages of 10 and 30. Over time, it seems to separate from the skin, and is located on a thin leg. It often then turns into a papillomatous nevus (verrucous nevus). A large number of irregularities, folds and crevices are formed in it, in which dead cells of the upper layer accumulate.

Here, pathogens can accumulate, which then lead to infectious processes. 5. Blue nevus has a characteristic color, since it is associated with deposits of melanin under the skin. Blue nevi are characteristic mainly of Asian nationalities. They rise slightly above the skin, dense to the touch, their surface is always smooth, hair never grows on it.

The blue nevus is small, most often no more than five millimeters. 6. The basal nevus also looks like a mole, but most often it has a normal flesh color. This is a non-pigmented nevus. 7. Seton's nevus (Seton's nevus, Sutton's nevus, halo nevus) is a special type of dermal nevus when there is a patch of skin completely devoid of pigment around the pigment spot.

The origin of such nevi has not yet been fully understood. They are often combined with vitiligo (loss of pigments by the skin), melanomas. Most often in the area of \u200b\u200bthe nevus halo there is a slight inflammation in the skin. 8. Nevus Ota. It is located on the face, on the one hand, in the form of "dirty" spots. 9. Ita's nevus resembles Ota's nevus, but it is located under the collarbone, on the chest, in the area of \u200b\u200bthe scapula and neck.

Both of these varieties are found mainly in Asian peoples. 10. Papillomatous nevus (verrucous nevus). A papilloma-like nevus is often large, located on the head or behind the neck, but can be located in other places. It has an uneven surface, like a wart.

Often hair grows on it. 11. Becker's nevus (epidermal hair nevus) - most often occurs in boys and young men 10 - 15 years old. First, several small spots are formed on the body, which have a light brown or brown color, and are located nearby. Then they merge and form spots with uneven contours up to 20 cm in size.