Image of the Week - Nevus Sebaceus of Jadassohn

"A 14-year-old girl came to the hospital with her mother, stating that a small birthmark on the scalp had recently started growing rather rapidly. It was increasingly pruritic and caused the patient considerable emotional distress. She was otherwise healthy. On examination a large multilobulated, verrucous lesion was seen on the scalp. The findings were consistent with nevus sebaceus. These lesions have a predilection for the scalp and typically appear early in life as a solitary, hairless patch or small plaque. Often they do not cause problems until the patient reaches adolescence, as hormonal factors induce a verrucous or nodular change and the lesion grows in size, occasionally rather dramatically. Given the size and location of the lesion and the risk of malignant transformation, especially to basal-cell carcinoma, later in life, the patient was referred to plastic surgery for excision. The lesion was successfully excised, and histologic examination confirmed the diagnosis of nevus sebaceus of Jadassohn."
Courtesy of: http://content.nejm.org/cgi/content/full/358/18/e20