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Diagnosis and management of benign lumps and bumps in childhood
Harper N Price1, Andrea L Zaenglein
1Department of Dermatology, Penn State, Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
Insights
Pediatric skin lumps like nevus sebaceus, pilomatricoma, and juvenile xanthogranuloma are common. Recent research clarifies their risks and diagnosis, aiding pediatricians in patient care.
Area of Science:
- Dermatology
- Pediatrics
- Oncology
Background:
- Skin disorders are frequent in pediatric outpatient visits.
- Common pediatric skin lesions include nevus sebaceus, pilomatricoma, and juvenile xanthogranuloma.
- Accurate diagnosis and counseling are essential for managing these conditions.
Purpose of the Study:
- To review recent literature on nevus sebaceus, pilomatricoma, and juvenile xanthogranuloma.
- To provide updated understanding of these common pediatric skin tumors.
- To enhance diagnostic accuracy and inform counseling for these lesions.
Main Methods:
- Literature review of recent articles on pediatric skin tumors.
- Analysis of updated findings regarding nevus sebaceus, pilomatricoma, and juvenile xanthogranuloma.
- Synthesis of information to improve clinical understanding and diagnosis.
Main Results:
- The risk of malignancy in nevus sebaceus in young patients is rare, challenging historical recommendations for early removal.
- Primary care physicians have low diagnostic accuracy for pilomatricomas, but key features can improve identification.
- The association of juvenile xanthogranuloma with neurofibromatosis and chronic juvenile myeloid leukemia is noted but requires further investigation.
Conclusions:
- Recent literature provides enhanced understanding of these three benign pediatric tumors.
- Increased familiarity with these lesions can lead to accurate in-office diagnosis.
- Informed counseling regarding risks and associations can be provided to patients and families.
Purpose Of Review:
In every pediatric practice, skin disorders make up a large percentage of outpatient visits. In this article, we highlight three of the most common 'lumps and bumps' seen in childhood: nevus sebaceus, pilomatricoma and juvenile xanthogranuloma.
Recent Findings:
Historically, many authors have advocated the prompt removal of nevus sebaceus at a young age due to the risk of malignant growths arising in these lesions during childhood. Recent articles have revisited this issue, concluding that the actual incidence of malignant growths in nevus sebaceus is quite rare in young patients. Regarding pilomatricomas, new findings show that the clinical accuracy of primary care physicians in diagnosing a pilomatricoma is low. With the identification of several key features, these lesions can be more easily diagnosed. Finally, the association of juvenile xanthogranuloma with neurofibromatosis and chronic juvenile myeloid leukemia has been described more formally in the recent literature, but the incidence and true association of this triad remain debatable.
Summary:
Several updates in the recent literature now afford greater understanding of these three benign pediatric tumors. With greater familiarity, an accurate diagnosis can often be made in the office and informed counseling regarding the risks or associations of these specific skin lesions can be performed.
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