TY - JOUR
T1 - Sebaceous Nevus of the Scalp
AU - Goel, Pedram
AU - Wolfswinkel, Erik M.
AU - Fahradyan, Artur
AU - Tsuha, Michaela
AU - Hough, Michelle
AU - Magee, William
AU - Hammoudeh, Jeffrey A.
AU - Urata, Mark M.
AU - Howell, Lori K.
N1 - Publisher Copyright:
© 2019 by Mutaz B. Habal, MD.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Excisions of scalp nevus sebaceous (NS) presents a unique challenge due to limited soft tissue laxity, hair-bearing skin, and convex surfaces which often leave the surgeon and patient underwhelmed with the reconstructive outcome. In this study, the authors conducted an institutional review board-approved retrospective review of patients who underwent excision of pathologically proven scalp primary NS from 2003 to 2017 at our institution to better define the reconstructive outcomes and options for treatment of pediatric scalp NS. 92 patients were included in the study, 54 males (58.7%) and 38 females (41.3%). The average age at surgery was 7.24 years (0.5-16.0; SD 4.7). Local tissue undermining/galeal scoring with primary closure (LTUGS) was used for lesions with average surface area of 3.6 cm2, rotational or transposition flaps (RF/TF) for lesions averaging 4.3 cm2, completed serial excision for lesions averaging 13.9 cm2, and tissue expansion (TE) for lesions averaging 21 cm2 (P <0.001). One or more poor outcomes were experienced by 35 patients (38%), with a significant difference between the surgical groups; LTUGS 37.2% (29/78), RF/TF 60% (3/5), serial excision 100% (3/3), TE 0% (0/6) (P = 0.022). Univariant binary regression analysis within the LTUGS and RF/TF groups showed that lesion size was a significant predictor of poor outcomes (P = 0.012). All specimens in this study were negative for carcinoma. Therefore, most pediatric nevus sebaceous of the scalp can be managed by a single-phase procedure though risk of poor outcomes increase with nevus size with high rates of poor outcomes even with small lesions.
AB - Excisions of scalp nevus sebaceous (NS) presents a unique challenge due to limited soft tissue laxity, hair-bearing skin, and convex surfaces which often leave the surgeon and patient underwhelmed with the reconstructive outcome. In this study, the authors conducted an institutional review board-approved retrospective review of patients who underwent excision of pathologically proven scalp primary NS from 2003 to 2017 at our institution to better define the reconstructive outcomes and options for treatment of pediatric scalp NS. 92 patients were included in the study, 54 males (58.7%) and 38 females (41.3%). The average age at surgery was 7.24 years (0.5-16.0; SD 4.7). Local tissue undermining/galeal scoring with primary closure (LTUGS) was used for lesions with average surface area of 3.6 cm2, rotational or transposition flaps (RF/TF) for lesions averaging 4.3 cm2, completed serial excision for lesions averaging 13.9 cm2, and tissue expansion (TE) for lesions averaging 21 cm2 (P <0.001). One or more poor outcomes were experienced by 35 patients (38%), with a significant difference between the surgical groups; LTUGS 37.2% (29/78), RF/TF 60% (3/5), serial excision 100% (3/3), TE 0% (0/6) (P = 0.022). Univariant binary regression analysis within the LTUGS and RF/TF groups showed that lesion size was a significant predictor of poor outcomes (P = 0.012). All specimens in this study were negative for carcinoma. Therefore, most pediatric nevus sebaceous of the scalp can be managed by a single-phase procedure though risk of poor outcomes increase with nevus size with high rates of poor outcomes even with small lesions.
KW - Pediatric
KW - scalp reconstruction
KW - sebaceous nevus
UR - http://www.scopus.com/inward/record.url?scp=85077295432&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85077295432&partnerID=8YFLogxK
U2 - 10.1097/SCS.0000000000006007
DO - 10.1097/SCS.0000000000006007
M3 - Article
C2 - 31725502
AN - SCOPUS:85077295432
SN - 1049-2275
VL - 31
SP - 257
EP - 260
JO - Journal of Craniofacial Surgery
JF - Journal of Craniofacial Surgery
IS - 1
ER -