Diagnosis and management of benign lumps and bumps in childhood

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.