Sebaceous Nevus of the Scalp

Pedram Goel, Erik M. Wolfswinkel, Artur Fahradyan, Michaela Tsuha, Michelle Hough, William Magee, Jeffrey A. Hammoudeh, Mark M. Urata, Lori K. Howell

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)257-260
Number of pages4
JournalJournal of Craniofacial Surgery
Issue number1
StatePublished - Jan 1 2020
Externally publishedYes


  • Pediatric
  • scalp reconstruction
  • sebaceous nevus

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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