A newborn is noted to have a well-demarcated, yellowish, hairless, velvety plaque on the scalp measuring 3 cm, with mammillated surface. It grows proportionally with the child and remains hairless. The pediatrician advises elective removal before puberty. What is the principal reason for this recommendation?

• A Risk of progression to a rapidly involuting congenital hemangioma
• B Risk of malignant transformation, particularly basal cell carcinoma, after puberty ✓
• C Association with ipsilateral cerebral calcifications and seizures
• D High likelihood of spontaneous ulceration and infection in infancy

Explanation

Nevus sebaceous (of Jadassohn) is a hamartomatous organoid nevus presenting at birth as a yellow-orange, hairless plaque on the scalp or face. During puberty, androgen stimulation causes it to thicken into a verrucous mass, and secondary adnexal tumors develop in a proportion of patients, including syringocystadenoma papilliferum and, less commonly, basal cell carcinoma, which justifies planned excision before adolescence. It does not transform into vascular tumors, ulcerate spontaneously, or carry the intracranial associations of Sturge-Weber syndrome.

Reference: Hurwitz Clinical Pediatric Dermatology, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.