Nevus sebaceous (NS) is a common congenital hamartoma of the skin, usually found on the head and neck. It may undergo malignant transformation to basal cell carcinoma (BCC). However the incidence and lifetime risk of malignant transformation is unknown. We performed an 18-year review of all NS excisions at our institution, to report the number of cases of BCC and other neoplasms within excised NS. The aim is to inform physicians who must weigh the risks in recommending excision of a NS in a pediatric patient population with the risk of malignancy. After a database query for years 1990-2008, charts were reviewed and data were extracted on demographics and surgical history relating to NS. Thirty-one NS with abnormal findings were reviewed microscopically by a dermatopathologist. There were 651 NS distinct lesions among 631 patients and 690 excisions. Twenty-one intralesional diagnoses were found in 18 patients. Five patients (0.8%) had BCC (mean age 12.5 yrs, range 9.7-17.4 yrs). Seven (1.1%) had syringocystadenoma papilliferum (SP) (mean age 8.8 yrs, range 1.7-16.9 yrs), a lesion that may undergo malignant transformation. Malignant transformation of NS can occur in childhood or adolescence. We believe all NS should be excised, however timing of excision can be flexible. Our data do not support age cutoffs or morphologic changes to determine optimal excision time. In conjunction with the treating physician, the parent and patient may weigh the small risk of malignant transformation of NS against the morbidity associated with excision and anesthesia.Nevus sebaceous (NS) is a congenital skin lesion commonly seen by pediatricians, dermatologists, and plastic surgeons. It occurs in fewer than 1% of neonates, and was first described by Jadassohn in 1895 (1). Nevus sebaceous is a congenital hamartoma of the skin, defined by hyperplasia of the epidermis, hair follicles, and sebaceous and apocrine glands. It manifests in infancy as a raised, finely papulated alopecic plaque that is usually Address correspondence to Brian I.
VSGS is an effective means of providing temporary continuous drainage of CSF in PHH with an acceptable complication rate. VSGS has many advantages that make it superior to VAD as a temporizing shunt.
The aging face results in increase in laxity of the skin and the underlying supporting tissue. There is a fundamental volume loss in the face and it is most apparent in the midface. A traditional superficial musculoaponeurotic system (SMAS) rhytidectomy addresses the laxity of the face but not volume loss. Multivector high SMAS plication allows for natural excess tissue to be placed into the area of volume loss, thereby addressing midface volume loss. This technique is easy to perform, reproducible, and effective with the added benefit of helping to volumize the lower face.
Poster PresentationsP245 patients and specifically those in which surgical intervention is performed. This study investigated potential risk factors for de novo or refractory otitis media in this older age group who required pressure equalization tube (PET) insertion.Methods: A retrospective study was performed at a tertiary care academic hospital for children 6 to 12 years old undergoing PET insertion between October 1, 2010, and September 30, 2011. The data were stratified into 2 separate age cohorts (6-7 versus 8-to 12-year-olds) for analysis.Results: A total of 263 patients met the inclusion criteria. PET insertion was more common in the 6-year-old age group (36%, 95/263), which decreased by age with a negative relationship. No significant sex-based difference was observed. Presence of siblings (P < .05), otalgia (P < .05), otorrhea (P < .001), nasal discharge (P < .001), and trends of parental smoking (P = .09) and hearing loss (P = .06) were identified in the older cohort. No statistical significance was found for history of recurrent acute otitis media (RAOM), allergy, asthma, or atopy between the 2 groups (P = .22-.97).Conclusions: The older cohort (ages 8-12 years old) had more infectious symptoms including otalgia, otorrhea, and nasal discharge than the younger cohort (ages 6-7 years old). In contrast, history of RAOM, allergy, asthma, and atopy were not significantly different between these age groups. Overall, this study provides further understanding of pertinent risk factors in older children requiring new or recurrent PET insertion.
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