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Sudden Nodular Growth in a Congenital Facial Lesion

John L. Snow, MB, ChB; Mark J. Zalla, MD; Randall K. Roenigk, MD; Lawrence E. Gibson, MD
Arch Dermatol. 1995;131(9):1069-1070. doi:10.1001/archderm.1995.01690210099017.
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REPORT OF A CASE  A 68-year-old man presented with a 1-month history of change within a lifelong lesion on his left cheek.The patient reported the growth of a new nodule, which he had noticed bled with minimal trauma.Examination revealed a 1.5×1.0-cm poorly marginated, reddish, and somewhat translucent nodule arising within a 3-cm linear, orange yellow plaque that had a cobblestonelike texture (Figure 1). A biopsy specimen was taken (Figure 2). Tissue from the subsequent excision was also examined microscopically (Figure 3).What is your diagnosis?

DIAGNOSIS:  Squamous cell carcinoma arising in a nevus sebaceus of Jadassohn (NSJ).

HISTOPATHOLOGIC FINDINGS AND CLINICAL COURSE  The biopsy specimen of the nodular lesion showed an infiltrating, keratinizing, epithelioid tumor arising from the epidermis. There was a moderately intense lymphocytic inflammatory response surrounding the tumor. The subsequent excision specimen revealed a dilated follicular infundibulum filled with keratinous material, subtle


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