A 1-year-old boy has a well-demarcated yellowish, waxy hairless plaque over the left scalp present since birth. The paediatrician notes the lesion may develop secondary tumours after puberty. The most appropriate management recommendation is:
- A Surgical excision, ideally around or after puberty if deferred earlier ✓
- B Daily topical retinoid to flatten the plaque
- C Reassurance only, as malignant change never occurs
- D Intralesional triamcinolone to arrest growth
Correct answer: A. Surgical excision, ideally around or after puberty if deferred earlier
Explanation
Nevus sebaceus of Jadassohn is an organoid hamartoma with sebaceous, apocrine and epidermal components. During childhood it is flat and yellowish, becoming verrucous and more prominent at puberty under androgenic stimulation. Secondary benign tumours are common and malignant tumours, mainly trichoblastoma and rarely basal cell carcinoma or squamous cell carcinoma, can arise, hence complete surgical excision is recommended, commonly planned around puberty if not performed earlier. Topical retinoids and intralesional steroids have no role.
Reference: Fitzpatrick's Dermatology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.