Nevus Sebaceus of Jadassohn: A Clinicopathological and Dermoscopic Study with Management Implications

Abstract

Objective: Nevus sebaceus (NS) of Jadassohn is a congenital hamartoma that undergoes stage-dependent morphological changes. Although malignant transformation is rare, long-term monitoring is advised. To describe the clinical, dermoscopic, and histopathological features of NS and to assess dermoscopy-histopathology correlations. Methods: Twenty-five patients were retrospectively analyzed over 2.5 years. All patients underwent clinical staging and dermoscopy. Biopsy procedures were performed in 15 patients, and complete histopathological data suitable for analysis were available for 13 (52.0%) patients. Fisher\"s exact and Spearman\"s correlation tests were used. Results: Mean age was 17.9 +/- 11.9 years (range: 3-43); 56.0% were male. Lesions were mainly on the scalp (60.0%). Clinical staging identified infantile (28.0%), early proliferative (24.0%), verrucous (32.0%), and nodular (16.0%) lesions. Mean age differed significantly across stages (analysis of variance, p=0.045), though overlap between groups suggested staging is not determined by age alone. Yellowish globules were significantly associated with early stages (p=0.005), whereas grayish papillary structures were confined to advanced stages (p=0.005). Arborizing vessels and brown globules were more frequent in advanced lesions but not statistically significant. Histopathology revealed basaloid epidermal proliferation, immature hair follicles, immature sebaceous glands, and perifollicular inflammation ascommon features. No statistically significant dermoscopy-histopathology associations were identified. No malignant transformation was observed. Conclusion: Dermoscopy provides stage-dependent diagnostic clues in NS and complements histopathology as a non-invasive tool for evaluation and follow-up. Conservative surveillance may be appropriate in selected low-risk cases, whereas surgical excision remains recommended for advanced or clinically suspicious lesions.