Jadassohn's nevus in a newborn: surgical treatment or conservative tactics

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Abstract

BACKGROUND: Jadassohn's nevus (seborrheic nevus, nevus of the sebaceous glands) is a hamartoma which is mainly localized on the scalp and face skin. At birth, it looks like a barely noticeable light yellow plaque which significantly increases at the puberty period under androgenic stimulation. The histological picture of Jadasson's nevus is characterized by changes in the epidermis in the form of acanthosis, papillomatosis, hyperkeratosis, and a large number of hyperplastic sebaceous glands. Pluripotent epithelial cells, which are part of the hamartoma, may provoke the growth of secondary benign and malignant tumors. This nevus may be manifested by Schimmelpenning–Feuerstein–Mims syndrome which can damage the nervous system and eyes. Currently, there are no uniform recommendations for the management of patients with Jadassohn's nevus.

CLINICAL CASE DESCRIPTION: In this article, we present our own experience of treating two children discussed pathology. The first boy had a radical surgery at the age of 16 days of life because of large dimensions of the nevus and a significant cosmetic defect. Removal of the formation at the neonatal period has prevented the development of rough postoperative scars and promoted good cosmetic outcome due to high elastic and regenerative properties of baby's skin. In the second child, Jadasson's nevus looked like a barely noticeable light yellow plaque; therefore, conservative tactics was chosen for this patient. Both children were consulted by a neurologist and an ophthalmologist who found no pathology in the nervous system and in the vision organs.

CONCLUSION: The described two clinical examples demonstrate the need for individual and multidisciplinary approaches in the management of patients with Jadasson's nevus. Active surgical tactics should be applied because of a significant cosmetic defect rather than for the prevention of malignant transformation which is met in less than 1% of cases.

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About the authors

Irina A. Karyakina

Morozov Children's Municipal Clinical Hospital

Author for correspondence.
Email: kariyakina@mail.ru
ORCID iD: 0009-0002-4034-8776
SPIN-code: 9711-9742

MD, Dr. Sci. (Medicine)

Россия, 4th Dobryninsky Lane 1/9, buil. 21, 119049 Moscow

Mikhail G. Rekhviashvili

Moscow Regional Center for Maternal and Child Health; Russian University of Medicine

Email: dr.rekhviashvili@yandex.ru
ORCID iD: 0000-0003-2256-6198
SPIN-code: 8467-3155

MD, Cand. Sci. (Medicine)

Россия, 6 Mira street, 140014 Lyubertsy, Moscow region; Moscow

Irina G. Bazina

Morozov Children's Municipal Clinical Hospital

Email: mdgkb-facial@morozdgkb.ru
ORCID iD: 0000-0003-1116-2729
SPIN-code: 1698-9752

MD, Cand. Sci. (Medicine)

Россия, 4th Dobryninsky Lane 1/9, buil. 21, 119049 Moscow

Nina N. Bogatyreva

Morozov Children's Municipal Clinical Hospital

Email: centrpath@yandex.ru
ORCID iD: 0000-0002-7786-5075
SPIN-code: 2609-9662

MD

Россия, 4th Dobryninsky Lane 1/9, buil. 21, 119049 Moscow

Kristina D. Propletkina

The Russian National Research Medical University named after N.I. Pirogov

Email: kislinka2000@yandex.ru
ORCID iD: 0009-0000-4095-7614

MD

Россия, 1 street Ostrovityanova, 117997 Moscow

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Supplementary files

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2. Fig. 1. View of the patient at 5 day age: a — the right temporal region; b — the right temporoparietal region.

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3. Fig. 2. View of the patient a�er biopsy: a — the right temporal region; b — the right temporoparietal region, the formation has been partially removed.

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4. Fig. 3. Macroscopic picture of the removed fragment of the formation.

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5. Fig. 4. Microscopic picture of the bioptat: a, b, e — epidermis with pronounced papillomatosis; a, b, d — epidermis with pronounced acanthosis and hyperkeratosis, formation of keratin pseudocysts; b, c — ulcerative foci and reactive inflammatory infiltration; b–d, f — large number of intradermal hyperplastic sebaceous glands; hematoxylin-eosin staining; magnification ×10 (a–c, e, f), ×40 (c).

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6. Fig. 5. Patient after surgery.

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7. Fig. 6. A child at the age of 2 years: a — the scar is covered with the hair under usual head position; b — the normotrophic lambdoid scar in the right temporoparietal region.

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8. Fig. 7. Patient at the age of 6 days.

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Copyright (c) 2024 Karyakina I.A., Rekhviashvili M.G., Bazina I.G., Bogatyreva N.N., Propletkina K.D.