Nevus sebaceous and Epidermal nevus: Ultrasound differentials.

Publication of my Handbook on Skin Ultrasound is Progressing, my new editor Jeny Ruelo has infused me new energy in this hard and long way of publishing.

With respect to hamartomas in some cases, there is difficulty in stablishing correct diagnosis from clinical point of view.

How can ultrasound help me in differentials with nevi (epidermal and sebaceous)?

CLINICAL CASE

A 45 year old phisician came  to my  office complaining of changes in congenital scalp lesion observed in the followin image

Differential diagnosis may include epidermal and sebaceous nevi

Ultrasound of this plaque is performed

ULTRASOUND REPORT

Heteroechoic hypoechoic  ill definned  subepidermic area in scalp with minimal epidermal thickenning

Histologic diagnosis: Sebaceous nevus

We had anothe case of epidermal  nevi that differed from this in ultrasound aspect

ULTRASOUND REPORT

Homogeneous hypoechoic  subepidermic area in scalp  epidermal thickenning

Histologic diagnosis: Epidermal nevi

CONCLUSIONS

• Skin ultrasound can be applicated to scalp lesions
• As it can be observed ultrasound may be useful in the differential diagnosis of these two entities and of hep in presurgical planning.