Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2025;15(1):4951 1

Multiple Basal Cell Carcinomas Arising  
in Nevus Sebaceous

Ugnė Tiškevičiūtė1, Enzo Errichetti2, Veronica Lestani2, Giuseppe Stinco2, Noemi Plozner1

1 Lithuanian University of Health Sciences, Kaunas, Lithuania

2 Institute of Dermatology, Department of Medicine, University of Udine, Italy

Citation: Tiškevičiūtė U, Errichetti E, Lestani V, Stinco G, Plozner N. Multiple Basal Cell Carcinomas Arising in Nevus Sebaceous. 
Dermatol Pract Concept. 2025;15(1):4951. DOI: https://doi.org/10.5826/dpc.1501a4951

Accepted: September 1, 2024; Published: January 2025

Copyright: © Tiškevičiūtė et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, 
distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing Interests: None.

Authorship: All authors have contributed significantly to this publication.

Corresponding Author: Dr. Noemi Plozner, Institute of Dermatology, Department of Medicine, University of Udine; Piazzale Santa Maria 
della Misericordia, 15. 33100 – Udine, Italy. Tel: (+39) 0432559822. E-mail: noemiplozner@hotmail.it

Case Presentation

A 58-year-old woman was referred to our clinic for a 5-month 

history of a growing pigmented papule in the context of a 

nevus sebaceous (NS) on the right temporal area measuring 

about 8.0 cm x 2.0 cm (Figure 1A). On dermoscopic exam-

ination, the pigmented papule showed blue-gray globules/

ovoid nest and focused arborizing vessels (Figure 1B) con-

sistent with basal cell carcinoma (BCC). Besides this lesion, 

we also detected several smaller BCCs on dermoscopy  

(Figure 1C and D). The patient underwent surgical ex-

cision and histological examination of a bigger lesion, 

with confirmation of diagnosis, and cryotherapy of the 

smaller ones.

Teaching Point

NS is a benign skin lesion that has the potential to develop 

into secondary tumors [1]. While most of these secondary 

tumors are benign, NS can also be associated with malignant 

tumors such as BCC, squamous cell carcinoma, or sebaceous 

carcinoma [1]. A recent meta-analysis revealed that 12.8% of 

NS cases develop into secondary tumors, with 10.3% being 

benign and 2.4% malignant, predominantly BCC (1.7%) [1]. 

Typically, BCC arising from NS is solitary, but in rare cases, 

it can be multiple, as seen in our case, which complicates 

management [1,2]. Close follow-up, including dermoscopic 

examination, is necessary for these patients to promptly rec-

ognize initial lesions and avoid extensive surgeries.



2 Image Letter | Dermatol Pract Concept. 2025;15(1):4951

References

1. Pang S, Cevik J, Sreedharan S, Wilks DJ. Rate of Benign and Ma-

lignant Secondary Tumors Associated With Nevus Sebaceous: 

A Systematic Review and Meta-Analysis. Ann Plast Surg. 2024 

Jun 1;92(6):711-719. DOI: 10.1097/SAP.0000000000003879. 

PMID: 38725109.

Figure 1. (A) Clinical examination shows a pigmented papule (arrow) in the context of 

a nevus sebaceous (NS) on the right temporal area. (B) Dermoscopy reveals blue-gray 

 globules/ovoid nest and focused arborizing vessels. (C, D) Dermoscopic examination also 

revealed several smaller basal cell carcinomas.

2. Tyczyńska K, Krajewski PK, Chlebicka I, Szepietowski JC. 

 Nevus Sebaceous with Multiple Basal Cell Carcinomas and 

 Extracutaneous Abnormalities: Genetic Origin or Coincidence? 

Acta Dermatovenerol Croat. 2022 Nov;30(3):174-177. PMID: 

36812277.