Clinicopathological Spectrum of Nevus Lipomatosus Superficialis: Insights From a Single-Center Study

Nevus lipomatosus superficialis (NLS) is a rare benign cutaneous hamartoma characterized by mature adipose tissue in the dermis. Clinically, it appears as soft, skin-colored or yellowish papules or nodules. It manifests in classical or solitary form, often misdiagnosed as lipofibroma, acrochordon, or papillomas. NLS is frequently misdiagnosed because its clinical and cytological features overlap with those of subcutaneous lipomatous lesions, while its defining characteristic (ectopic adipocytes within the dermis) is only evident on histopathological examination. This study describes the clinico-histopathological features of the solitary variant of NLS to minimize diagnostic inaccuracy.

Fifteen histopathologically confirmed NLS cases were studied over two years, with clinical presentations and morphology of lesions systematically analyzed and tabulated.

A strong female preponderance was noted (male-to-female ratio = 1:14), with a mean age of 39.5 years. The thigh (five cases, 33.3%) and buttocks (four cases, 26.7%) were the most common sites, followed by the back (two cases, 13.3%) and the nape, axilla, inguinal region, and shoulder (each 6.7%). All lesions were of the solitary variant. Histology showed epidermal atrophy and mature adipocytic dermal lobules mixed with collagen. Clinically, all cases were misdiagnosed, with NLS being confirmed only after histopathological examination.

NLS is a rare cutaneous malformation. In this study, all histopathologically diagnosed NLS cases were of the solitary variant with a female predominance. However, larger studies are needed to confirm these patterns. Accurate clinical and histopathological recognition is crucial to avoid misdiagnosis with other common benign skin lesions.