Skip to main content
Log in

Neoplastic skin lesions of the scalp in children: A retrospective study of 265 cases in Taiwan

  • Clinical Report
  • Published:
European Journal of Dermatology

Abstract

Background

The preferential occurrence of certain skin neoplasms on the scalp of children raises concerns from their parents and warrants special diagnostic and therapeutic approaches.

Objective

To explore the demographic and clinical characteristics of scalp neoplasms in the pediatric population, with attention to malignant tumors and systemic syndromes.

Methods

Scalp neoplasms in patients aged 12 years or younger were retrospectively collected in 1990–2010 from two tertiary referral centers in Taiwan.

Results

A total of 267 scalp neoplasms in 265 pediatric patients were recruited. Among the 209 neoplasms with a histopathological diagnosis, nevus sebaceus was the most common (67.9%), followed by melanocytic nevus (6.2%) and juvenile xanthogranuloma (6.2%). Most of the scalp neoplasms (77.9%) were seen at birth or before 1 month of age. Infantile hemangioma was clinically diagnosed without histology in 41.4% of cases. Malignant scalp tumors were identified in two patients (0.95%), with one basal cell carcinoma and one precursor B-cell lymphoblastic lymphoma, respectively. Scalp neoplasms in association with systemic syndromes were found in two cases. One had neurofibromatosis type I with juvenile xanthogranuloma and the other basal cell nevus syndrome with basal cell carcinoma.

Conclusions

Most pediatric scalp neoplasms in our study were hamartomas or teratomas. Malignant scalp tumors and malignant transformation of nevus sebaceus were rare. A detailed medical history taking and complete physical examinations are needed to exclude possible associations with systemic syndromes or malignancies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Moody MN, Landau JM, Goldberg LH. Nevus sebaceous revisited. Pediatr Dermatol 2012; 29: 15–23.

    Article  PubMed  Google Scholar 

  2. Beer GM, Widder W, Cierpka K, et al. Malignant tumors associated with nevus sebaceous: therapeutic consequences. Aesthetic Plast Surg 1999; 23: 224–227.

    Article  CAS  PubMed  Google Scholar 

  3. Cribier B, Scrivener Y, Grosshans E. Tumors arising in nevus sebaceus: A study of 596 cases. J Am Acad Dermatol 2000; 42: 263–268.

    Article  CAS  PubMed  Google Scholar 

  4. Rosen H, Schmidt B, Lam HP, et al. Management of nevus sebaceous and the risk of Basal cell carcinoma: an 18-year review. Pediatr Dermatol 2009; 26: 676–681.

    Article  PubMed  Google Scholar 

  5. Jaqueti G, Requena L, Sanchez Yus E. Trichoblastoma is the most common neoplasm developed in nevus sebaceus of Jadassohn: a clinicopathologic study of a series of 155 cases. Am J Dermatopathol 2000; 22: 108–118.

    Article  CAS  PubMed  Google Scholar 

  6. Mehregan AH, Pinkus H. Life History of Organoid Nevi. Special Reference to Nevus Sebaceus of Jadassohn. Arch Dermatol 1965; 91: 574–588.

    Article  CAS  PubMed  Google Scholar 

  7. Santibanez-Gallerani A, Marshall D, Duarte AM, Melnick SJ, Thaller S. Should nevus sebaceus of Jadassohn in children be excised? A study of 757 cases, and literature review. J Craniofac Surg 2003; 14: 658–660.

    Article  PubMed  Google Scholar 

  8. Aguilera P, Puig S, Guilabert A, et al. Prevalence study of nevi in children from Barcelona. Dermoscopy, constitutional and environmental factors. Dermatology 2009; 218: 203–214.

    Article  PubMed  Google Scholar 

  9. Gupta M, Berk DR, Gray C, et al. Morphologic features and natural history of scalp nevi in children. Arch Dermatol 2010; 146: 506–511.

    Article  PubMed  Google Scholar 

  10. Fernandez M, Raimer SS, Sanchez RL. Dysplastic nevi of the scalp and forehead in children. Pediatr Dermatol 2001; 18: 5–8.

    Article  CAS  PubMed  Google Scholar 

  11. Tcheung WJ, Bellet JS, Prose NS, et al. Clinical and dermoscopic features of 88 scalp naevi in 39 children. Br J Dermatol 2011; 165: 137–143.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. McCarthy B. Melanoma of the scalp and neck had greater risk of melanoma-specific mortality than melanoma of the extremities. Evid Based Med 2008; 13: 155.

    Article  PubMed  Google Scholar 

  13. Zalaudek I, Leinweber B, Soyer HP, et al. Dermoscopic features of melanoma on the scalp. J Am Acad Dermatol 2004; 51: S88–S90.

    Article  PubMed  Google Scholar 

  14. Lu CI, Chang YC, Lai CH, et al. Rudimentary meningocele of the scalp. Dermatol Sinica 2003; 21: 394–401.

    Google Scholar 

  15. Al-Khateeb TH, Al-Masri NM, Al-Zoubi F. Cutaneous cysts of the head and neck. J Oral Maxillofac Surg 2009; 67: 52–57.

    Article  PubMed  Google Scholar 

  16. Marrogi AJ, Wick MR, Dehner LP. Benign cutaneous adnexal tumors in childhood and young adults, excluding pilomatrixoma: review of 28 cases and literature. J Cutan Pathol 1991; 18: 20–27.

    Article  CAS  PubMed  Google Scholar 

  17. Lan MY, Lan MC, Ho CY, et al. Pilomatricoma of the head and neck: a retrospective review of 179 cases. Arch Otolaryngol Head Neck Surg 2003; 129: 1327–1330.

    Article  PubMed  Google Scholar 

  18. Mammino JJ, Vidmar DA. Syringocystadenoma papilliferum. Int J Dermatol 1991; 30: 763–766.

    Article  CAS  PubMed  Google Scholar 

  19. Chang MW. Update on juvenile xanthogranuloma: unusual cutaneous and systemic variants. Semin Cutan Med Surg 1999; 18: 195–205.

    Article  CAS  PubMed  Google Scholar 

  20. Chiou CC, Wang PN, Yang LC, et al. Disseminated xanthogranulomas associated with adult T-cell leukaemia/lymphoma: a case report and review the association of haematologic malignancies. J Eur Acad Dermatol Venereol 2007; 21: 532–535.

    PubMed  Google Scholar 

  21. Zvulunov A, Barak Y, Metzker A. Juvenile xanthogranuloma, neurofibromatosis, and juvenile chronic myelogenous leukemia. World statistical analysis. Arch Dermatol 1995; 131: 904–908.

    Article  CAS  PubMed  Google Scholar 

  22. Cambiaghi S, Restano L, Caputo R. Juvenile xanthogranuloma associated with neurofibromatosis 1: 14 patients without evidence of hematologic malignancies. Pediatr Dermatol 2004; 21: 97–101.

    Article  PubMed  Google Scholar 

  23. Wright TS. Cutaneous manifestations of malignancy. Curr Opin Pediatr 2011; 23: 407–411.

    Article  PubMed  Google Scholar 

  24. Shih YC, Lin WL, Shih IH. Langerhans cell histiocytosis in Taiwan: a retrospective case series in a medical center. Dermatol Sinica 2009; 27: 93–102.

    Google Scholar 

  25. Chiu CS, Lin CY, Kuo TT, et al. Malignant cutaneous tumors of the scalp: a study of demographic characteristics and histologic distributions of 398 Taiwanese patients. J Am Acad Dermatol 2007; 56: 448–452.

    Article  PubMed  Google Scholar 

  26. Ratnam KV, Khor CJ, Su WP. Leukemia cutis. Dermatol Clin 1994; 12: 419–431.

    Article  CAS  PubMed  Google Scholar 

  27. Knight PJ, Reiner CB. Superficial lumps in children: what, when, and why? Pediatrics 1983; 72: 147–153.

    CAS  PubMed  Google Scholar 

  28. Baldwin HE, Berck CM, Lynfield YL. Subcutaneous nodules of the scalp: preoperative management. J Am Acad Dermatol 1991; 25: 819–830.

    Article  CAS  PubMed  Google Scholar 

  29. Bartlett SP, Lin KY, Grossman R, et al. The surgical management of orbitofacial dermoids in the pediatric patient. Plast Reconstr Surg 1993; 91: 1208–1215.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to WenChieh Chen.

Additional information

C-C Yang and Y-A Chen contributed equally to this work.

Part of the work was presented at the 9th European Academy of Dermatology and Venereology Spring Symposium, Verona, Italy, June 6–10, 2012.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yang, CC., Chen, YA., Tsai, YL. et al. Neoplastic skin lesions of the scalp in children: A retrospective study of 265 cases in Taiwan. Eur J Dermatol 24, 70–75 (2014). https://doi.org/10.1684/ejd.2013.2216

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1684/ejd.2013.2216

Key words

Navigation