Fifteen-Year Retrospective Analysis of Sebaceous Nevus on the Head Focusing on Scar Revision

Abstract

　　Sebaceous nevus (SN) is usually resected at an early age to avoid malignant transformation with age. However, some patients with SN on the head develop cicatricial alopecia after resection and require scar revision. We retrospectively analyzed 86 patients (43 men and 43 women, 13.6±14.1 years old) who underwent surgical resection of SN between 2004 and 2018 focusing on scar revision. The operative method was simple resection in 67 patients, local flap in 7, and two-stage resection with tissue expander (TE) in 12. The average width of resection was 14.4 mm for simple resection, 19.1 mm with a local flap, and 27.4 mm with a TE, and the differences were significant. Ten patients (11.6%) required scar revision for postoperative cicatricial alopecia, with a significant difference among the surgical groups; simple resection 11.9% (8/67 patients) , local flap 28.6% (2/7 patients) , and TE 0% (0/12 patients) (P=0.02) . Although resection with a TE requires two operations, it is an efficient method to prevent cicatricial alopecia of the scalp, especially in patients with wide SN lesions.