Nevus Sebaceus (not SebaceOus!)...Explained by a Dermatopathologist

[@JMGardnerMD]

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

[@ramadanshatwan2205]

As usual very nice presentation. Many thanks for all your amazing videos

[@harshalranglani9844]

Your videos are amazing! I'm a Dermatology resident and these are helping me a lot!

[@DistinctlyMeFilms]

I had nevus sebaceus up until about 5 years ago when I got it removed. It made me very embarassed because anytime someone would do my hair they would talk about my "wart" or say I'd need to go to the doctor. My mom just ignored them and reassured me because I had, has it since I was a baby. But of course I was young and stupid and constantly picked at it hoping it was like a scab and I could pick it off? Anyways eventually I did do the surgery and I feel better though I do find myself touching the scar a lot. I'm glad that there are videos like this that we can now show and educate people!

[@JMGardnerMD]

I’m glad you found the video helpful. Even benign skin lesions can be frustrating sometimes or cause people to feel self conscious. I try to teach my students the importance of this aspect of dermatology. Just because it isn’t cancer or isn’t dangerous doesn’t mean it isn’t serious for the patient. Thank you for sharing your story! Best wishes for good health! Jerad

[@cadenlewis1801]

Does hair grow after romoval?

[@loveandlifepodcast]

Story of my life 😔

[@DistinctlyMeFilms]

@@cadenlewis1801 Nope. Theres just a thin scar there

[@cadenlewis1801]

@@DistinctlyMeFilms how small bc itd my biggest insecurity and always cover it up

[@deepshikhagaire6802]

I am pathology resident. great video Dr Gardner. Thanks

[@JMGardnerMD]

Nevus sebaceus (spelled without the O). A "nevus" (from Latin for "birthmark") without melanocytes. Summary: Yellowish hairless plaque on the scalp of kids. Epidermal acanthosis +/- papillomatosis (can mimic seborrheic keratosis or verruca/wart). Large sebaceous glands open directly to skin surface. Apocrine glands often present in underlying dermis. Can give rise to a variety of (usually benign) adnexal tumors.

[@trentbasis3724]

If I have had this excised twice (about the size of a dime, stitched back together) by a dermatologist, and now it appears to be coming back again. What is going on to cause that?

[@JMGardnerMD]

Links to my videos about the other entities and histology structures I mention in this video: - Skin adnexal structures - normal histology: kzbin.info/www/bejne/r4K0Y3ejr5lljNUm49s - Apocrine hidrocystoma: kzbin.info/www/bejne/o56raoOZqK-Jfdk - Syringocystadenoma papilliferum (SCAP) 1 (longer): kzbin.info/www/bejne/q4CXZ6mqjpKdbNE - Syringocystadenoma papilliferum (SCAP) 2 (shorter): kzbin.info/www/bejne/jaCkmXtvbK6KfrM - Seborrheic keratosis and verruca vulgaris: kzbin.info/www/bejne/mpq7mmSEndlpgq8 - Seborrheic keratosis: kzbin.info/www/bejne/iIfCZ3qYZZeHrNk

[@missknowall]

Many thanks for another amazing video. I was thinking of requesting you to please make one on histology of hair and various alopecias. Looking at the comments I find I am not alone, quiet a crowd in fact!! So can we hope?

[@JMGardnerMD]

Alopecia is still so hard for me. I am no expert in it. But maybe I can cover some basics in future.

[@missknowall]

Looking forward😊😊!!

[@bosnian_beauty]

This what you are doing is fantastic. Thank you very much, its very helpful.

[@lavleensingh9644]

wonderful explanation. love your videos dr.Jerad

[@kezaevangelista9490]

Your videos are helpful I'm a Dermatology resident. Please show videos of scarring and non scarring alopecia disease and autoimmune blistering diseases! Thanks a lot!

[@tamilarasirenganathan8243]

Thank you so much. Very concise and informative video with interesting slides.

[@belabotum876]

Dude I’m an esthetician and you’re busting me up lol then you had to show the mites lol my son has a nevus sebaceous I’m having a dermatologist look at on March 11th papillominus and verucus looking so these excision and histology videos give me hope. Sry I’m a nerd. Ty 🙏

[@JMGardnerMD]

Hope all goes well for your son. Best wishes!

[@Exquisite-xd9me]

Thank you for informative and detailed video, really helpful.

[@loudefeo2510]

Another great presentation.Thank you

[@AysiaKaliann]

I just made a video on what it’s like growing up with nevus sebaceus if anyone is interested in watching it! 💞💞

[@JMGardnerMD]

Thank you!

[@jisellerodriguez3331]

I am 30 years old and I have had one since I was born and never got it removed. And lately I have notice some pain and some bleeding at times. I do not scratch it because it is never itchy until the last few weeks. It has been very annoying and very itchy

[@azzaal-helo5300]

you R amazing... thanks a lot hope in the future you make a video about neuroblastoma and ganglioneuroblastoma.

[@branislavasimic4102]

Hello! I have a nevus in the left corner of my forehead since birth. I am now 25 years old and a few days ago a blue dot appeared in my nevus. So far there have been no problems. Do I have reason to be afraid? In my country this is unexplored and I am very grateful that I came across your video. Thank you.

[@aldricartillo]

I have that thing on my head and I want to get rid of this . Is it dangerous when u consult and remove it to a doctor?

[@bavidlynx3409]

If i get my nevus removed can i get hair transplant on that spot? Will it work

[@JMGardnerMD]

Hmmm, I don’t know actually. I don’t have any experience with hair transplants. This would be a good question to ask your dermatologist. If you find out the answer please let me know!

[@uneekg6991]

This is the reason for my hair loss and I've been wandering the same

[@MelMelrainbow]

I have one of these in my head ever since birth, I'm 27 years old and I don't like when people touch it I've hit it on things before and it's on the back center of my head I've had CAT scans done before and other things but should I look into getting it removed? Is it going to affect my life later down the line?

[@scottandrews2138]

Hi, I'm a 48 yr old in western PA. I have a long-standing Nevus Sebaceous (birth mark). I recently noticed it was changing (crystallizing, itching, feeling more bumpy). Close up photo showed it looking scaly. Biopsy found Squamous Cell Carcinoma growing inside. My dermatologist seemed to know very little about this and said I surprised him with the cancer... and that this was pretty rare. He said he thinks he got it all out and then said to see him in 6 months ~ no testing to see if he actually got it all? He then talked about UV sunburns, etc. However, that would be unrelated if inside a Nevus Sebaceous, no? I read this combination has shown to be the more aggressive kind, or "subtype"... and that the biopsy could show the subtypes and help determine treatment. The lab is in Tampa FL. They refused to provide me any details because my Demonologist had yet to paid the bill. Would a pathology report typically show squamous cell subtypes and/or any indication of level of aggression? I read one 42 yr old w/this combination was dead in 11 months. I think I caught this earlier then him though... but I'm not sure and weeks are going by without any new info. I'm new to all this so apologies for getting terms/speln's wrong :)

[@JMGardnerMD]

That is very strange. I have seen many different types of tumors grow out of nevus sebaceus but most of them are benign. I’ve never seen squamous cell carcinoma arise from one, although there are very rare reports of this in the literature. Most squamous cell carcinoma of the skin is successfully treated by surgical removal, although occasionally it can be more aggressive. I’m not familiar with the report you mention about a case of this killing a patient in less than a year. That would be very unusual behavior for squamous cell carcinoma of the skin. Do you have a link to the case report where you read this? I’m curious to learn the medical details. I have heard of rare cases of fatal apocrine carcinoma from nevus sebaceus, but that is a very different type of cancer. The pathology report will usually mention if there are aggressive features in a squamous cell carcinoma ( like poor differentiation or perineural invasion). Given the unusual situation, it might be worth having the case sent to an expert for a second opinion. The lab where the original pathology was performed should be willing to give you a copy of the pathology report and to send the slides to another pathologist for second opinion. If they won’t, you can ask your dermatologist to help you coordinate it. There are many good experts you could send it to. I am a big fan of Phil LeBoit and colleagues at UCSF. There are also great Dermpaths at Cleveland Clinic, Yale, Harvard, and many places around the USA. You could have it sent to any of those.

[@scottandrews2138]

Jerad Gardner Hey! Thank you so much for the reply. I will push on the lab in Tampa again and also try with my dermatologist as well once I know where to go. My understanding is some places might be set up with an on-site lab and could keep scraping off cells until the tests show the cancer is totally removed? The Cleveland Clinic you mentioned seems to be at my maximum drivable range. I will go there if they are the best and can do that iterative testing? More drive-friendly than that though: I frequently travel in the Baltimore area. Pittsburg & Philadelphia are also reachable for me. I want to go somewhere like you said - where there are experts and I want to leave knowing the cancer has been removed. Can you share a contact or site/location for me to look up? Your videos are awesome btw - well explained even for the layman who has to pause and look up terms :)

[@JMGardnerMD]

You can just have slides sent to an expert to look at them and confirm diagnosis. You won’t have to drive for that. They will fedex them. Then you can get info about if margins are positive or negative or if extra surgery is needed. Yes, the procedure you are talking about is called Mohs surgery. And thanks for the comments about my videos!

[@acrustykrab]

Treatment for benign?

[@shivendrajha961]

Hello sir, I am dermatology resident would you please post a slide of scaring and non scaring alopecia and approach to alopecia slide Thank you

[@JCnKC]

Question...... Have you ever heard of one of these “birth marks” being on the top, back part of a child’s 👂 ear?

[@inaayatabassums]

My child's entire ear is systematized with nevus. His ear is 3 times larger than the normal ear. The nevus extending toward his scalp, neck and cheek.

[@xojeanetteg3741]

@@inaayatabassums hello how is your son doing Did he get it treated

[@ericmartin9569]

Doctor, I have one and everytime a doctor tries to remove it with electrocautery it makes the nevus worse looking. Throughout time it has become more noticeable and I hate it. It's on my face

[@oluwatosinadegboye8533]

I love your illustrations, thanks for always sharing your knowledge, your last slide with background BCC, if I have a similar case will it be wise to diagnosed it as BCC straightway or nevus sebaceus with background BCC, since a malignant neoplasm supercede a benign lesion.

[@JMGardnerMD]

I’d say BCC arising in nevus sebaceus. But remember that most things that look like BCC in nevus sebaceus are actually benign hair follicle tumors (like trichoblastoma or trichilemmoma).

[@oluwatosinadegboye8533]

@@JMGardnerMD thanks

[@alexmarquez7338]

Should a 12 year old get it removed and does it hurt?

[@JMGardnerMD]

They are benign. But some patients/parents want them removed for cosmetic reasons and some dermatologists prefer to have them removed. Many different skin diseases can look alike so it’s important to see a board certified dermatologist to be sure of the diagnosis and to get advice about if any treatment is needed. Best wishes.

[@brayandls1731]

Help im 16 and i think i have this thing nevus sebaceus is it deadly??is it really that serious my parents always thought it was hust a birthmark but i did some research and im scared i have it on my scalp its warty

[@JMGardnerMD]

First, take a deep breath. Nevus sebaceus by itself is totally benign and not deadly. The important thing is to be sure that you actually have nevus sebaceus and not some other skin lesion. Dermatology is hard even for doctors, and even more so for patients. So trying to diagnose yourself is very difficult to do, and as you search google you will freak yourself out with all the crazy things you will read about. Seeing a board certified dermatologist is a great idea. They can examine you and help figure out for sure whether you have nevus sebaceus or something else. In the meantime, don't get too worried. The vast majority of skin lumps/bumps/marks in 16 year old patients are benign and not deadly. So do go and see a dermatologist, but don't lose sleep or be anxious while you wait for your appointment. Best wishes for your health. - Jerad

[@brayandls1731]

@@JMGardnerMD thanks for replying less worried but a month ago around around my scar there is a small scar which is really small its separeted from the big one i have....the big one is maybe 2 inches long that one is only warty flat ...but the smaller one that is closed to my big one it came like a wart type it became rounded it was also warty flat like the big one but its like a small ball now like a wart...sorry if im not explaing myself good

[@safsaelbashier2831]

Thanking you

[@karenvillarreal4603]

Hello! Just found out my son has this, should I be worried? He’s about to be one.

[@JMGardnerMD]

Nevus sebaceus is a common and benign skin lesion. It can be a cosmetic issue but VERY rare for it to cause any real problems. I’m the dad of 3 young kids…if my kid had a nevus sebaceus, I wouldn’t lose any sleep over it. But Please discuss with your dermatologist to figure out what is best for your son. Best wishes for good health.

[@feamisola7864]

how much cost for this surgery? please reply in philippines

[@JMGardnerMD]

I don’t do surgery. I do not know how much it costs. Please discuss with your doctor.

[@jensenmontoya5745]

San ka sa pilipinas lods same tayu meron din ako nyan Umay satin WAHAHAHHAH ATLEAST BUHAY TAYU WHAHAHA

[@bellasnews4668]

I had 2 on my head but i got them removed now I think I have one on my ear and you shouldn't feel ashamed or scared if you have it because honestly the surgery is fun and easy and after you will have baby butt skin on your head [or where ever yours is] soo yea just wanted to say that

[@oogabooga5752]

Did you have to pay or was it covered by insurance? I looked into getting it removed but it costs too much :/

[@bellasnews4668]

@@oogabooga5752 Insurance!

[@oogabooga5752]

@@bellasnews4668 my doctor keeps telling me it won't be covered by insurance despite it giving me discomfort (physically and mentally), so I didnt even bother trying to call my insurance. Maybe I'll try calling now. I want this thing gone lol. THANK YOU

[@bellasnews4668]

@@oogabooga5752 Good! I'm so glad I can help

[@lolaoopa2953]

Hello I am 15 years old turning 16 in about a week I have one above my ear it was diagnosed when I was young and the doctor said it's nevus sebaceous and not dangerous and we can remove it later but I refused to remove it. it's colour was changing between black, grey and pink but since many years it stayed on grey colour but sometimes gets darker or lighter. I feel it sometimes so itchy and paiful sometimes I don't feel it. 3 months ago I used to scratch it so hard and it sometimes bleeded and its borderes became very weak now I stopped doing that it became not so painful but still painful. I find dead black cells coming out from it. the sking around it is weak and strange things appear on it but I remove them by hand. I sometimes feel pressure in its area and the area around it and sometimes I feel headache I asked a doctor and he told me it may be because using headphones as I wear them most of the day and with high volume. I find also swollwen big movable lymph nodes in my neck in its side and others are small and hard. is it serious?

[@JMGardnerMD]

Sorry to hear you are having a medical issue. There is no way for me to know exactly what’s going on in your case and I can’t give advice since you aren’t my patient. But for general info: Nevus sebaceus can get irritated and inflamed sometimes. They can change and grow as a person goes through puberty. Also a variety of other tumors (usually benign ones) can grow inside nevus sebaceus. These tumors are usually benign and very rarely anything serious but to be safe you should see your dermatologist to discuss whether or not it should be biopsied or removed now, especially since it is changing and causing discomfort. In the meantime don’t be afraid or worried. I’ve seen many cases of nevus sebaceus but only very rarely seen it turn into something serious, and those cases were all in adults not in teens or kids. So go see your doctor but be at peace in the meantime. Best wishes for good health to you! :-)

[@lolaoopa2953]

@@JMGardnerMD Thanks alot for the answer you made me feel safer

[@aninditabora1740]

I have all the same issues like you.. Are you alright now?

[@ahmedaljabal515]

I have one at the moment and i just got know about the term nevus sebaceous (or sebaceus). I visited a dermatologist today and he said just to leave it alone unless i want to sergically remove it, but when i asked him for his oppinion, he then froze it with a spray (not sure exactly what is it called). Going back home from a dermatologist, I needed to make sure what he said and did (freeze) was actually right. Your video helped me a lot and thank you so much for that, but i just need to ask you just one thing, what is the best treatment for it?

[@JMGardnerMD]

I’m so glad the video helped you. These are benign. They may be removed surgically if the patient wants to have it removed. I’m not sure about the role of liquid nitrogen or other treatments as I’m a dermatopathologist not a dermatologist. I specialize in diagnosing skin disease microscopically but I don’t treat it. If you have further questions I would recommend you discuss with your dermatologist. Best wishes for good health! Jerad

[@JMGardnerMD]

I’m so glad the video helped you. These are benign. They may be removed surgically if the patient wants to have it removed. I’m not sure about the role of liquid nitrogen or other treatments as I’m a dermatopathologist not a dermatologist. I specialize in diagnosing skin disease microscopically but I don’t treat it. If you have further questions I would recommend you discuss with your dermatologist. Best wishes for good health! Jerad

[@Timillion]

these tumors are not fun, painful to comb your hair, apparently can transform into malignant in rare cases, annoying. Ratings: 0/10 don't recommend having it. Thanks to this P.O.S, after surgery I managed myself to get an infection, causing pain in the area where it was removed. And for that I give it -1/10. But because while my stiches were removed (some unprofessional nurses) it caused pain in which I would describe migraine on steroids. And once again, I give it --∞/10.

[@olliethetabby]

I have a nevus sebaceous and I’m grateful to say that its small and by my hairline on the side but not in my hair so its barley noticeable and it’s probably been mentioned twice my whole life.. im 15 and pick at it so plan on getting it removed soon

[@girlsclub7558]

Helo i am from India i am also 15 i want to know that you're ok and what's symptoms on me has you too so please reply me it will make me feel safe i had also nevois sebaceous

[@xojeanetteg3741]

How are u doing Did u get it removed

[@girlsclub7558]

@@xojeanetteg3741 do u have too

[@SandhyaRamachandran]

GREAT one Jerad. Am a practising pathologist but still "always" find pearls in ur videos ! recently had such a case - a verrucous lesion on the scalp since birth in a 11 yo child... there were many hair shafts altho clinically they said "hairless area"..was thinking of a seb ker but not sure if the latter can be congenital ! settled finally on a dx of an Epid nevus! Does an Epid nevus come in the d/d ??

[@JMGardnerMD]

Absolutely. Epidermal nevus looks very similar. It just usually lacks the big sebaceous glands and other adnexal structures. If it looks like seborrheic ketosis in a child, it’s most likely either epidermal nevus or nevus sebaceus. Both are benign hamartomas so the distinction isn’t usually important clinically.

[@SandhyaRamachandran]

thanks so much !

[@gemstone3750]

So my daughter has this on her head, she’s 5 now, I shouldn’t worry about it? It is getting bigger but I assume that’s cause her head is getting bigger. Do I need to remove it now when she’s young? Or is that a cosmetic issue?

[@JMGardnerMD]

I can’t give you personal advice since she isn’t my patient. But I can tell you some general information. These lesions are benign. Patients/parents sometimes choose to remove them either for cosmetic reasons or if they are itchy/painful/irritating to patient. Skin cancer can grow from these but only very rarely in my experience and when this does happen it is usually in adults. I also have a 5 year old daughter. If she had a nevus sebaceus I would probably just watch it and wait until she was older to remove it unless it started to grow quickly or ulcerate/bleed. skin surgery can usually be done while patients are awake but this is sometimes more difficult for young kids to handle. So for a benign issue I personally would wait until my kid was older. That is just my own personal view for my own children. But I know some doctors who choose to remove them while the child is still young. You should visit a board certified dermatologist so the lesion can be examined by an expert and then you can discuss risks vs benefits of removal now vs later vs not removing it at all. Hope that is helpful. Best wishes.

[@gemstone3750]

Thank you so much for replying! Sorry, my question was so short, I was on an iPad. We've gone to a dermatologist every year since she was born and they just look at it and say "she's fine" but then some family members web MD it and have been pressuring me to remove it bc cancer came up with their search (cancer comes with everything on internet lol). After watching your video and reading online, I think the best solution right now is to wait till puberty hits and see if changes from the flat velvety bald patch to the bumpy one. I guess I worry about her being able to hid it with her hair when she's older. It's on the side of her head and even you have to pull her hair up a certain way to hide it....and kids are jerks and tease about everything lol.

[@JMGardnerMD]

Yes, google search is both a wonderful and dangerous thing! It can be very hard to sort out what to worry about or not for non-medical folks when reading online. Glad to hear you’re seeing a dermatologist. If/when it starts bothering her, your derm can advise you about removal options. Best wishes.

[@bosnian_beauty]

I think this kind of video is educational, patients can get help with their GP.

[@raynecameron]

I have a Nevus and I want to get it removed

[@JMGardnerMD]

Please be sure to visit your dermatologist so they can examine you and give you advice about how to proceed. Best wishes.

[@goharrehman7710]

very good

[@belabotum876]

He’s almost 16 with autism so it started to grow at puberty. Also has thyroid.

[@cruse1177]

I used to have one .

[@inaayatabassums]

How did you get it treated ? My child's havin one. He has it on his ear, scalp and neck. and his affected ear is 3 times larger than the normal ear

[@girlsclub7558]

I have one and it's growing day by day since puberty my parents saying this a birthmark but watching this they will be sure me to take skin doctor but i don't know in India they will take serious or not i want removal from medicine and i afraid of surgery i am 15 can I do surgery and i m sure it's nevois sabaceous

[@JMGardnerMD]

It is a kind of birthmark actually. It rarely causes any major issue but many patients choose to have them removed. To my knowledge, there is no medicine to remove it…surgery is the only way to remove it that I know of. It is a relatively simple procedure. Please discuss things with your parents and your dermatologist so you all can figure out what is best for you. Best wishes for health and happiness to you and your family. 😊

[@thecaptainnoah]

Are most dermatologist familiar with this type of Birthmark ? Asking for a friend 😅?

[@JMGardnerMD]

Yes dermatologists are very familiar with this

[@dockilat5576]

@@JMGardnerMD Doc I just had a specimen of Nevus Sebaceous (from the ala nasi) and it was awesome. However I forgot to look for clues in your channel, it could've been faster diagnosing if I already saw it here, anyways it was also in the Rosai Pathology book. I'm a Pathology resident from Philippines and your channel has been a great source of Dermapath info. Keep it up!

[@bricurran3466]

I was born with this but on my face

[@JMGardnerMD]

Scalp is the most common site but I’ve seen it occur on the face and occasionally other places like the chest.

[@itsdefinitelysophiexx1]

Hi! I’m 15 years old and I’m 100% sure i have this but my mother doesn’t want to take me to a derm because she says it’s just a birthmark. I’m afraid it might be malignant, when I hit puberty this birthmark turned from yellow to pink and started growing a lot I also picked at it and ruptured some of the tumors growing from it, after a while it got very scaly and smaller, now it is a lot smaller and scaly. Is it dangerous that i picked at it? I’m literally so afraid, Sorry for my bad english, I’m not a native speaker. Also I’m not even sleeping well at night because I’m thinking so much of it, oh and it is located on my temple. I would be so happy if you would respond since I’m desperate! ❤️

[@JMGardnerMD]

Since I’m not your doctor I cannot diagnose you or give you official advice but I can give you some general information. Nevus sebaceus Actually IS a type of birthmark... that is correct. It is benign and not malignant. Very very rarely cancer can grow from it but I’ve only seen that a few times in my career and it has always been in adults not in teenagers in my experience. It is totally normal and common for nevus sebaceus to grow and change during puberty due to hormone changes acting on the sebaceous glands in the lesion. So I hope that makes you feel a little bit less worried but I do think that you are right to want to see a dermatologist about it. This will help you be sure of the diagnosis and will help you feel better about things I think. Have you told your mother how worried you are about this and how you’re losing sleep over it? If you explain to her how worried it’s making you feel and that it would make you feel better to see a dermatologist just to be sure of things, that might help convince her that you need to see a dermatologist. Or you can just show her this comment and see if this helps convince her. Best wishes to you for health & happiness. -Jerad.

[@itsdefinitelysophiexx1]

Thank you so much, made me feel much better, I will show her this comment and I hope she will understand! Wish you the best!

[@AysiaKaliann]

ItsDefinitelyMario you should watch my new video 👌🏼👌🏼 show it to your mom 👍🏼 I had precancerous skin cells and had to get it removed so I would definitely take it to get looked at atleast once (: if there is anything they will be able to remove it and you’ll be okie dokie