Should Be Removed or Taken Biopsy in Early Stage: A Retrospective Study of 953 Cases of Nevus Sebaceous From a Single Center

No consensus was made on whether all Nevus sebaceous (NS) should undergo prophylactic excision and the best age of surgery. This is a retrospective study. Patients who underwent surgery and were confirmed as NS by pathology during January 2014 to December 2023 in the Department of Dermatology of Xinhua hospital were included in this study. A total of 953 cases were included, composed of 536 males and 417 females. Most patients underwent their first surgery as adolescents (mean 12.5 years). Scalp (66.4%) and face (26.1%) were the most common sites. General anesthesia was rarely used in patients older than 5 years in this series. Fifty-two tumors developed in 46 cases, including 44 benign and 8 malignant (BCC). The most common benign tumors arose from hair follicles (22 tumors) and apocrine glands (17 tumors), especially syringocystadenoma papilliferum (n = 14), trichilemmoma (n = 10), and trichoblastoma (n = 6). In patients aged 5-12 years, 13 benign tumors and 2 BCC cases (ages 10.1, 10.3 years) were observed, with the youngest being a 4.7-year-old with SCAP. We identified 15.1 years as the cut-off age of tumor presence in the resected NS lesion. At this single center, diffuse and multifocal lesions tended to be resected at a younger age than lesions located on the face. Resection of NS led to a marked reduction in patient-reported psychological discomfort burden scale (p < 0.05). The malignant tumor rate was low. However, in patients under 12 years, 13 benign tumors and 2 BCC cases were observed. Given benign tumor occurrence in childhood and BCC over 10 years, monitoring should begin at 10 years and resection is recommended before 15.1 years as tumor risk increases. Suspicious lesions should be excised regardless of age. Resection of NS could improve psychological well-being.