The child has a nevus of the sebaceous glands. What is the nevus of the sebaceous glands of yadasson, the stages of its development in a child, methods of diagnosis and treatment

Nevus Jadassohn is a neoplasm on skin human, arising from pathology sebaceous glands. The disease manifests itself in the form of a tumor on the skin in those places on the head where sebaceous glands change under the influence of a number of factors.

This can happen in utero, at birth, or within a few years after the baby is born. Histological examination and a specific morphological picture will make it possible to establish a diagnosis and select an appropriate method of therapy.

Seborrheic nevi are equally often observed in female and male patients, developing against the background of proliferation, malformation of apocrine glands, hair follicles, epidermal cells.

Skin lesions may be beige or pale pink. They do not grow hair and have benign character, that is, they do not pose a danger to human health. But in the presence of a number of negative factors, a small plaque on the head can turn into a dangerous one. malignant tumor.

The causes of the formation of Yadasson's nevus have not been fully established. official medicine, but there is a list of factors contributing to the development of the pathology of the sebaceous glands:

A plaque on the scalp can degenerate into a malignant tumor with hyperplasia. Previously, several plaques on the scalp or in the region of the human face merge into one large formation from 2 mm to 10 cm in diameter with a limited, bumpy surface.
Nevi appear in those people who have a genetic predisposition to this disease. The defective gene is passed to the child from one of the parents, increasing the likelihood of a typical nevus degenerate into a dangerous cancer.
With prolonged manifestation of rosacea on the skin. Such a symptom cannot be ignored: a person needs to consult a dermatologist so that simple rashes do not provoke malignancy of seborrheic plaques.
Pathology is more often diagnosed in patients suffering from chronic systemic diseases. Especially, inflammation of the gastrointestinal tract, which long time left without adequate treatment.
Provoke nevi and environmental factors: irritants of thermal and chemical nature. Therefore, people with a predisposition to this disease should avoid prolonged exposure to the scorching sun in summer and outdoors in winter, carefully select products for hair, face and neck skin care.

Sebaceous nevi can provoke an adenoma located on the face or part of the head with hairline. Adenomas increase in size slowly, corrode the skin, leave deep defects, but they respond well to treatment.

Timely contacting a medical institution increases the risks of maintaining the aesthetics of the scalp and preventing the recurrence of the disease.

Stages of disease development

Seborrheic nevus is a disease in which the sebaceous glands gradually deform and lose their main functions. This leads to the appearance of neoplasms on the skin, which is popularly called a mole of fat content.

Plaques can form on the skin even in the prenatal period of fetal development, in an infant at birth, as well as in older children.

Genetically, a nevus is rarely transmitted from parents to children, in most cases this disease is sporadic. The disease develops in three stages, depending on the degree of change in the function of the sebaceous glands:

The first stage is characteristic of infants and children of the first years of life. The nevus is pale pink in color, hairless, smooth, but has papillae. It responds most well to treatment, rarely recurs after surgical removal.
The second stage is typical for teenagers. The formations look like spherical papules, closely adjacent to one another. They are yellowish or light brown in color and visually resemble warts.
The third stage is diagnosed in adolescence. Nevus at this stage is dangerous for human health, since malignancy can occur in its thickness. The older a person becomes, the more likely malignancy of the neoplasm on the scalp. In every 4th patient, a specialist determines hydradenoma, basiloma, papillary cystadenoma. Slightly less commonly diagnosed squamous cell carcinoma, tumors of apocrine glands, infundibulomas.

Important! The growth of the glandular tissue of the sebaceous glands can be dangerous to human life, since it often transforms into a rapidly progressive adenocarcinoma. With extensive skin lesions, its epidermal structure is disturbed, the risk of recurrence of the disease after surgical treatment increases.

In the presence of such a problem, it is worth undergoing an examination, choosing the most suitable method of treatment for a particular patient. This will help reduce the likelihood of recurrence of the disease and the formation of cancerous processes on human skin.

Symptoms of pathology

Nevus Yadasson is not characterized by systemic symptoms. A neoplasm appears on the skin of the scalp during fetal development or after birth. It grows slowly, thickens, gradually rising above the surface of the skin.

As a result, seborrhea acquires a papillomatous appearance, and every 10th case is characterized by neoplastic changes that look like nodules or ulcers.

Medicine also knows cases when the disease was accompanied by the following symptoms:

visual anomalies;
disturbances in the work of the central nervous system;
skeletal pathologies.

During the diagnosis, it is required to differentiate the nevus with other neoplasms.

Diagnostic methods

With a nevus on the head, you will need to collect an anamnesis, paying attention to the time the formation appeared. The doctor should check with the patient or his relatives if anyone in the family has had similar cases. General inspection and laboratory diagnostics will allow you to make an accurate diagnosis by differentiating the usual nevus from skin cancer, dermal aplasia, solidary mastocytoma, papillary nevus.

The latter disease is distinguished by a particularly intense pink color of the plaques on the skin, and the mastocytoma is characterized by a completely different structure.

To finally clarify the diagnosis, determine the depth of the neoplasm and characterize its features, histology is carried out. You can prevent the development of cancer by checking for atypical cells.

Also, if necessary, it is worth taking a smear that determines the risk of degeneration of the neoplasm, but you need to understand: the procedure is accompanied by injury to the nevus, which increases the risk of its degeneration into a malignant tumor.

Treatment of nevus Yadasson

Treatment of pathology is carried out exclusively on the recommendations of a specialized specialist. Attempts to treat or remove a nevus on their own can provoke irreversible consequences: the degeneration of the formation into a malignant tumor. Most effective method The solution to the problem is the surgical removal of the nevus, however, it is indicated only before the age of the patient's puberty.

The excision of the neoplasm is carried out under general anesthesia or local anesthesia on a thin strip with a healthy epithelium. If one operation does not completely remove the tumor of the sebaceous glands, it is excised in stages with minimal interruptions between procedures.

It is necessary to carry out the operation exclusively in oncological clinics, and it is important to send each remote area of the epithelium for histological analysis.

After removal of the nevus, a seam must be applied to the edges of the wound. But if the size of the formation is excessively large or it is located on the face, neck, chest, it is worth using a skin graft. The seam is closed with a sterile bandage. Dressing and treatment with an antiseptic is done every day for a 7-day period after the operation. After the wound has healed, the stitches are removed.

There are other types of removal of neoplasms on the skin of the head:

using a laser;
cryodestruction;
electrocautery.

But these methods of treating a nevus cannot guarantee the patient a complete recovery, since they do not exclude the risk of re-growth of the skin formation.

The details of nevus removal are described in the following video:

Probability of malignancy

Nevus Yadassohn in rare cases can degenerate into a malignant tumor: basal cell carcinoma occurs in 15% of cases. Even less often, an epithelial adenoma of benign etymology can develop. Perhaps the appearance of concomitant diseases such as blepharitis or rhinophyma. Most dangerous complication Nevus is a basal cell carcinoma that occurs in patients 40 years of age or older.

Malignancy occurs as a result of trauma to the skin neoplasm, therefore it is important to protect the affected area of the skin from mechanical damage, exposure sunlight, low temperatures.

On a note! Plaques are often located on the skin in the scalp, so the formation can be injured by a comb when combing the hair.

Since the tumor is benign, in itself it does not pose a danger to human health and life, however, its traumatization, hormonal changes in the body and other factors can provoke the degeneration of a nevus into malignant neoplasm. Therefore, experts recommend removing the problem before the child reaches puberty.

Most often, a nevus of the sebaceous glands is found on the head or on the face near the hairline. On the body, such formations appear extremely rarely. It is detected during a visual examination, most often even in the hospital.

Education has a round or oval shape, in rare cases - linear. Initially, it looks like a fatty plaque with an elastic structure and a velvety surface. The color of the nevus is from pink to sand-orange.

In some people, the plaque acquires uneven edges over time, and its surface becomes covered with cracks and papillomas. They can bleed and become infected, which makes the situation very difficult.

Important: at the site of the formation of a nevus, hair stops growing due to damage to the follicles.

Otherwise, apart from aesthetic problems, the disease does not cause any worries in the initial stages. Over time, changes in the structure of tissues associated with tumor processes may occur.

Causes

In most cases, a nevus of the sebaceous glands is found in newborns. It is extremely rare for the disease to develop in older children and adolescents. In this regard, pathology belongs to the category of congenital.

The exact reasons that cause it are not clear. Maternal diseases can affect the intrauterine development of a child, a genetic factor plays a certain role. In older children, the following factors can provoke violations of the structure of the sebaceous glands:

heredity;
rosacea;
chronic diseases of the gastrointestinal tract;
exposure to chemicals;
thermal influence.

Stages of development

The nevus of the sebaceous glands of Yadasson develops in several stages. At each of them, tissue changes acquire more and more threatening consequences. There are 3 stages in total:

Initial. Under the influence of certain factors, hyperplasia of the sebaceous glands occurs, involving hair follicles and apocrine glands in the process.
Mature. It is characterized by the manifestation of acanthosis. Education progresses, the sebaceous and apocrine glands increase, and the hair follicles gradually atrophy. In the structure of the nevus, changes occur associated with the development of papillomas.

Tumor. In the structure of education, a tumor process is born, which can create a real threat to the health of the patient.

Age changes

The external manifestations of the pathology and the structure of the plaque depend on the age of the child. The nevus of the sebaceous glands goes through several stages of modification as the patient grows older.

Infant age. The surface of the formation is smooth and velvety, has a papillary structure.
Adolescence. The plaque grows, its surface becomes bumpy and striated, the color becomes darker. There may be pain upon contact with the nevus.
Mature age. In the structure of the seborrheic nevus, tumor cells are born, as evidenced by the appearance of erosions on its surface, as well as the formation of nodular seals in the thickness of the tissue.

Risks and consequences

Nevus Yadasson is a rather dangerous health problem. This is due to the fact that processes of cell regeneration can occur in its structure. In some cases, everything is limited to a benign tumor. However, quite often a nevus degenerates into a malignant disease, which requires immediate medical intervention.

Important: the least dangerous is basalioma, as it has a low degree of aggressiveness and does not metastasize to other tissues.

In general, the following pathologies can develop:

hydradenoma;
basalioma;
cystoadenoma;
adenocarcinoma;
common sebaceous nevus.

In rare cases, the disease provokes disorders in the central nervous system, organs of vision, and the vascular system. There may be signs of mental retardation in a child, seizures of epilepsy.

Diagnostics

Diagnosis of the disease is carried out by examining the affected area and taking tissue samples for analysis. histological studies. This allows you to find out the nature of the formation and timely determine the presence of malignant cells in it.

It is necessary to carry out differential diagnosis with the following pathologies:

papillary syringocystadenomatous nevus;
solitary mastocytoma;
skin aplasia;
juvenile xanthogranuloma.

Treatment Methods

Treatment is carried out exclusively by removing the formation.

To remove the formation, the following methods are used:

electrocoagulation;
cryodestruction;
radio wave resection;
laser removal;
traditional surgery.

Modern methods of removing neoplasms are suitable for small nevi that have not passed into a late stage. Their advantage lies in the possibility of using local anesthesia, speed of execution and minimal consequences. In particular, there are practically no scars after the operation.

It is almost impossible to prevent the development of the disease, but it is possible to avoid negative consequences associated with it. In any case, it is necessary to be observed by a doctor both before undergoing the main treatment and after to prevent relapses.

A colleague sent a patient for a consultation, and I had the opportunity to take a rather rare photo - the growth of basal cell carcinoma against the background of Yadassohn's nevus.

In principle, such a photograph and such a case would probably be of interest only to specialists, if not for one “but”.

Nevus Jadassohn - most often congenital pathology. Benign, but prone to malignancy - in 5-30% of cases (and this is a lot), various tumors develop in these nevi, including malignant ones. More often - basal cell carcinoma, which is not particularly dangerous, but sometimes more malignant variants.

The patient sent for consultation lives with this nevus all his life, and the nodular formation appeared ... about 15 years ago. I will not comment on this and, moreover, I will not look for the cause in anyone (the patient did not turn to dermatologists / oncologists, and doctors of other specialties rarely encounter this type of nevus, and the patients themselves are used to living with it and do not show these nevi to doctors when they turn to them for other reasons), but rather I will describe the nevus itself.

This nevus is a malformation of the sebaceous glands, so it is also called sebaceous nevus. In two thirds of cases it is congenital, in one third of cases it manifests itself early. childhood. Very rarely, this nevus can manifest itself at a later age, in adolescents, but it happens. Sometimes there are family cases of the presence of these nevi.
It arises from the cells of the ectoderm (from which, among other things, our integumentary tissues are formed) due to mutations that have not been completely studied, and is a hypertrophied sebaceous glands, together with other glands and deformed hair follicles. Refers to hamartomas - benign tumors resulting from a violation of the embryonic development of organs and tissues, consisting of the same components as the organ where they are located, but differing in their incorrect location and degree of differentiation.

Outwardly, this nevus is a flat plaque, sometimes oval, sometimes asymmetrical, with a granular, warty surface and a yellowish tint. Sizes can be different - from half a centimeter to large, 10-centimeter formations. It is located more often on the scalp, but can be in other places. The nevus itself is not covered with hair, and its not very aesthetic appearance causes the fact that its owners begin to cover it with hair and not show it to anyone. Including doctors. Which is in vain.

By itself, the nevus does not cause any unpleasant sensations. With age, this nevus changes - for example, in childhood, the nevus is usually represented by a uniform fine-grained plaque of yellow-pink, pink, orange color, and in adolescence elements of the nevus are enlarged, it becomes more heterogeneous, sometimes sometimes with large warty elements.

Most often, this nevus does not cause any health problems, but, as mentioned above, in 5-30% of cases, various tumors, including malignant ones, can form in it.

This behavior of Yadasson's nevus is the reason why many experts recommend removing it before adolescence. However, this is not an unambiguous question.
Thus, from 1996 to 2002, researchers from the Miami Children's Clinic analyzed 757 cases of Yadasson's nevus removal in children under 16 years of age, and no cases of basal cell carcinoma were recorded in this group, and therefore the expediency of operations in childhood was questioned. A similar study, with fewer patients, had previously been conducted in France.

The feasibility of prophylactic removal in adults remains to be seen. open topic. In any case, both children and adults with the presence of Yadasson's nevus are shown periodic preventive examinations by an oncologist or dermatologist so that it does not work out like our patient.

Let's get back to it, though.
When viewed on the scalp of the patient, a formation of about 7 cm is determined, clinically interpreted as a nevus of Yadasson. On the surface of the nevus, nodular formations with areas of pigmentation are noted. With dermatoscopy, tree-like vessels are determined in nodular formations, based on a combination of signs, the clinical diagnosis is basal cell carcinoma that arose against the background of Yadasson's nevus.

The patient underwent a biopsy of the formation, histological verification:

The prognosis for life and health is favorable. Local recurrences of basal cell carcinoma are possible, but with adequate supervision by an oncologist, which I hope will now be carried out, nothing threatens the patient. The nevus, of course, will be removed completely, but this is quite an easily endured procedure.

Nevus Yadasson is a real benign tumor - these are defects that occur in the sebaceous glands. The disease was first described in 1985. You can quickly get rid of the sore.

A nevus of the sebaceous glands, or nevus of Jadassohn, is a tumor. It consists of small and clear-shaped plaques. They are either oval or linear. Yellowish with orange in color. You will notice that they are located above the level of the skin. There is hyperplasia of the sebaceous glands.

Such a nevus is very closely related to the warty and it is believed that they are both within the normal range. Yes, they need to be removed by babies in childhood or, in extreme cases, during adolescence. Nevus occurs in 0.3% of infants as a congenital neoplasm. It can be reborn and there will be an adenoma of the sebaceous glands. Required timely treatment.

In 70% of those who suffer from it, it was congenital. For others, it may develop into infancy and is less common in older children. Most often, it is an isolated case in the family, but there are also families in which many people have it and they had it removed in childhood. Women in adulthood or pregnant women may experience chloasma. These are spots on the face or thighs, abdomen. Chloasma in men is much less common.

In addition, there are atheromas, their occurrence is provoked by plugs in the sebaceous glands. Of course, an experienced dermatologist will immediately distinguish this sore from a nevus. I want to get rid of such diseases quickly.

Other formations on the skin

Chloasma does not appear in those who take care of themselves and lubricate the skin with sunscreen in the summer. In addition, chloasma will appear if there are problems with the gallbladder. Chloasma affects those who have a stomach ache and other digestive organs.

There is no such thing that in men hyperplasia of the sebaceous glands appears less frequently, and in women more often and vice versa. Its occurrence does not depend on your race. Most often, the nevus is located on the head at the border where hair begins to grow. It happens on the face. In other places it is also found, but very rarely.

Atheroma can appear in people of any age. It also happens on the head. A dermatologist understands that atheroma is when the ducts of your sebaceous glands are clogged, there are plugs and, in fact, atheroma is a cyst of the sebaceous gland.

If the nevus is outside, then the atheroma is inside under the skin. It is not noticeable on the head. She can be felt. In addition to the head, atheroma occurs everywhere in the body, where there are sebaceous glands and plugs and blockages can occur. Requires treatment.

The risk that the tumor will regenerate and become malignant increases with the age of the patient. So, in 25% of young men, the doctor can already say that the nevus has become a hydradenoma or papillary cystadenoma or basiloma. Much less often, but cancer (squamous) or infundibuloma can develop, as well as a tumor of the glands (apocrine).

Seborrheic nevus is dangerous. It can hit your eyes, spread to bone tissue, penetrate your nerve endings and directly into the central nervous system or urinary. Over time, Yadassohn's syndrome may occur. This is a linear nevus, the patient may experience intellectual retardation, epileptic seizures will occur.

Nevus of Yadasson in dermatology is called a tumor-like formation caused by malformation of the sebaceous glands (primarily), as well as other elements of the skin (connective tissue, apocrine glands, hair follicles).

In 70% of cases, Yadasson's nevus is a congenital formation. In other cases, education develops in infancy and, extremely rarely, in late childhood. Jadasson's nevus is sporadic in most cases, however, familial cases are sometimes observed. The distribution by race and gender is the same.

In most patients, the nevus of the sebaceous glands is formed on the scalp (usually at the border of hair growth), on the face. In other places, this formation rarely develops.

Reasons for development

What factors cause the development of Yadasson's nevus, it has not been possible to find out to date. One of the well-known reasons is.

Clinical picture

The nevus of Yadasson is manifested by the formation of a flat solitary plaque of an oval or (less often) linear shape. The consistency of the formation is soft-elastic, the color is pinkish, yellow, sandy or pale orange. The surface of the skin formation may be uneven, papillomatous. Sometimes there are signs and exfoliation of the epidermis with large scales.

Stages of development and clinical manifestations nevus are determined by the age of the patient:

In infancy, Yadasson's nevus has a smooth or. There is no hair growth in this area of the skin.
In adolescents, the skin formation changes - the focus can become larger, its surface is covered with furrows. The color of the formation becomes more pronounced - yellowish or pink-white. In some patients at this stage of development, the nevus becomes painful and extremely easily injured. And very often this one, although it is difficult to notice.
In patients of mature age, degeneration of the formation can be observed. In about 20% of patients, tumor growth is observed in the thickness of the nevus. The tumor can be either benign or be a form of cancer. Most often, nevus tissues are reborn into, into papillary or apocrine cystadenoma, basalioma, cancer of the apocrine glands or. A sign of tumor growth is the formation of new nodules in the tissues of the nevus or the development of erosions on its surface.

Nevus Jadassohn can often degenerate into a basalioma.

One of the most common options for the degeneration of the nevus of the sebaceous glands is the development of basalioma. This type of tumor develops in the tissues of the Yadassohn nevus much more often than benign tumors. Some patients develop both benign and oncological tumors.

It should be noted that with malignant degeneration of Yadasson's nevus, the disease proceeds with a lesser degree of aggressiveness than usual. Metastize tumors during the degeneration of the nevus sebaceous glands only in exceptional cases. There is a theory that the development of basalioma against the background of Yadasson's nevus is not a malignant transformation. Researchers view rebirth as differentiation epithelial cells and increase their proliferative.

A rare case is a common sebaceous nevus. In this case, the disease is systemic. Apart from skin symptoms patients are affected vascular system, eye, central nervous system, etc.

In exceptional cases, there is a syndrome of the sebaceous nevus of Yadasson, which is characterized by a triad of symptoms: epilepsy, mental retardation, nevi of the sebaceous glands of a linear shape.

Diagnostics

Diagnosis of sebaceous nevus is based on histological studies. The formations in this pathology have a lobular structure and consist of tissues of the sebaceous glands. The formation is located in the middle or upper dermis. In addition, there may be an expansion of the mouths of the apocrine glands.

Depending on the histological picture, three stages of development of education are revealed:

On the early stage hyperplasia of hair follicles and sebaceous glands is noted.
At the next stage, which is considered mature, phenomena are revealed. Papillomatosis is observed in the epidermis, a large number of sebaceous glands with signs of hyperplasia. The hair follicles are underdeveloped, and the apocrine glands are very well developed.
The last stage of development is tumor. The histological picture at this stage depends on the type of tumor that has developed.

Nevus Jadassohn should be distinguished:

from aplasia of the skin. With this disease, the formations have a smoother surface.
From papillary syringocystadenomatous nevus. This type of nevus is distinguished by an intense pink spotted color and a pronounced nodular surface.
From, in which the formation has a domed shape and differs rapid growth.
From solitary mastocytoma, which differs from the sebaceous nevus in its histological structure.

Treatment

Due to the fact that the risk of tissue transformation of the nevus is quite high, it is recommended to remove this formation before the onset of puberty.

Used to treat disease surgical method.

Application required surgical operation, since more gentle methods (cryolysis, electrocautery, etc.) lead to a re-growth of education.

It is necessary to completely excise the nevus within a thin strip of healthy tissue. If it is impossible to perform the operation at one time, a phased removal of pathological tissues is performed with minimal interruptions between operations. Since the sebaceous nevus is usually located on the head or face, the operation to remove it is considered difficult.

The operation to remove the tumor is carried out in medical institutions specializing in the treatment of cancer. The removed tissues are sent for histology, which allows you to determine the nature of the formation and identify or exclude the presence of atypical cells, indicating the onset of the malignancy process.

Removal of education is carried out under the general or local anesthesia depending on its size, location and age of the patient. After excision of pathological tissues, sutures are applied to the edges of the wound. With a large size of the formation or when it is located on the face, techniques will be applied plastic surgery, with the imposition of a skin flap on the defect site.

Placed on the site of the operation sterile dressing, then within a week it is necessary to make dressings and treat the postoperative wound with antiseptics. The stitches are removed after the wound has healed. There were no recurrences after the radical removal of Yadasson's nevus.

Prevention and prognosis

There are no measures that could prevent the formation of Yadasson's nevus, since the causes of its development are unknown.

The prognosis, in most cases, is favorable. Approximately 10% of patients develop against the background of a nevus. Less commonly, the formation degenerates into cancer of the sebaceous or apocrine glands. Prevention of malignancy of the formation tissues, it is recommended to remove it before the age of 12 years of the patient. After the radical operation There were no recurrences and development of basalioma at the site of the removed nevus.