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Nevus sebaceus of Jadassohn revisited with reconstruction options

Authors

  • Steven P. Davison DDS, MD,

    1. From the Divisions of Plastic and Reconstructive Surgery and Dermatology, Georgetown University Medical Center, Washington DC
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  • Amor Khachemoune MD, CWS,

    Corresponding author
    1. From the Divisions of Plastic and Reconstructive Surgery and Dermatology, Georgetown University Medical Center, Washington DC
      Amor Khachemoune, MD, CWS Division of Dermatology Georgetown University Medical Center 3800 Reservoir Road, NW, 5 PHC Washington DC 20007 E-mail: amorkh@pol.net
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  • Deborah Yu MD,

    1. From the Divisions of Plastic and Reconstructive Surgery and Dermatology, Georgetown University Medical Center, Washington DC
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  • Lisa C. Kauffman MD

    1. From the Divisions of Plastic and Reconstructive Surgery and Dermatology, Georgetown University Medical Center, Washington DC
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Amor Khachemoune, MD, CWS Division of Dermatology Georgetown University Medical Center 3800 Reservoir Road, NW, 5 PHC Washington DC 20007 E-mail: amorkh@pol.net

Abstract

Background  Nevus sebaceus of Jadassohn (NS) has the classic presentation on the head and neck of a yellow–orange-colored, waxy, pebble-like, papule or plaque. Its reported malignant potential varies between 0.8% and 50%. The common location of NS on the temporal hairline leaves a cosmetic defect.

Methods  We retrospectively reviewed a consecutive series of patients with NS located in the temporal scalp region. Thirteen patients were included. Twelve patients were reconstructed with a temporal flap. One patient had a primary linear scalp closure after excision. Clinical, histopathologic, surgical, and photographic records were used to review the clinical, anatomic, and pathologic presentation of the lesions. Reconstructions were rated on a scale of 1–5 by two independent examiners. The cosmetic results were also assessed by the patients.

Results  Patients ranged in age from 3 to 40 years. All of the lesions were located in the temporal area of the scalp. All cases were pathologically determined as NS. Two cases contained basal cell carcinoma (15%). Two cases were re-excisions of confirmed NS. One case was excised and closed with difficulty using a linear primary closure. Rotation flaps based on the superior temporal artery were used for the reconstruction of the defects in 12 patients. Nine of the flaps were anterior rotation flaps and three were posterior. The average score for the cosmetic results of the patients was 3.75, with the lowest score being 2, and the highest 5. The score for the linear closure was 2.

Conclusion  A rotation flap based on the superficial temporal artery is an excellent reconstructive solution for NS located in the temporal scalp region.

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