Neoplastic skin lesions of the scalp in children: a retrospective study of 265 cases in Taiwan.

BACKGROUND

The preferential occurrence of certain skin neoplasms on the scalp of children raises concerns from their parents and warrants special diagnostic and therapeutic approaches.

OBJECTIVE

To explore the demographic and clinical characteristics of scalp neoplasms in the pediatric population, with attention to malignant tumors and systemic syndromes.

METHODS

Scalp neoplasms in patients aged 12 years or younger were retrospectively collected in 1990-2010 from two tertiary referral centers in Taiwan.

RESULTS

A total of 267 scalp neoplasms in 265 pediatric patients were recruited. Among the 209 neoplasms with a histopathological diagnosis, nevus sebaceus was the most common (67.9%), followed by melanocytic nevus (6.2%) and juvenile xanthogranuloma (6.2%). Most of the scalp neoplasms (77.9%) were seen at birth or before 1 month of age. Infantile hemangioma was clinically diagnosed without histology in 41.4% of cases. Malignant scalp tumors were identified in two patients (0.95%), with one basal cell carcinoma and one precursor B-cell lymphoblastic lymphoma, respectively. Scalp neoplasms in association with systemic syndromes were found in two cases. One had neurofibromatosis type I with juvenile xanthogranuloma and the other basal cell nevus syndrome with basal cell carcinoma.

CONCLUSIONS

Most pediatric scalp neoplasms in our study were hamartomas or teratomas. Malignant scalp tumors and malignant transformation of nevus sebaceus were rare. A detailed medical history taking and complete physical examinations are needed to exclude possible associations with systemic syndromes or malignancies.