A Giant Nevus Lipomatosus Cutaneous Superficialis Treated With Serial Surgical Excision: A Case Report

Nevus lipomatosus cutaneous superficialis (NLCS) is a rare dermatological condition characterized by ectopic mature adipocytes in the dermis. The classic variety presents multiple clustered skin-colored nodules, while the solitary form is a single papule or nodule. We report the case of a 25-year-old female who presented with multiple cerebriform nodules coalescing into a large plaque over the left iliac region that developed over 17 months. Lesions ranged from 0.5 cm to 6 cm in diameter. Histopathology confirmed classical NLCS. Treatment options were discussed, and serial surgical excision was opted for for a better cosmetic outcome. The largest nodule was excised under local anesthesia, while the remaining were removed six months later under short general anesthesia as daycare surgery. At the six-month follow-up, only a hypopigmented patch persisted at the surgery site. Serial excision allowed staged removal of this large classical NLCS for an excellent cosmetic result. Early diagnosis and conservative treatment prevent disfigurement and morbidity in this rare condition. Clinicians must recognize NLCS since therapeutic choices are restricted for widespread lesions of the classical subtype.