Selected pediatric skin tumors: An update for dermatologists

There are a vast number of benign and malignant skin tumors that present in the pediatric population. This monograph addresses a select few of specific dermatologic interest. The first, Langerhans' cell histiocytosis, is a condition with clinical findings often confused with less serious common pediatric skin conditions, yet it can have significant morbidity. The genodermatoses are syndromes that can present with both benign and malignant skin tumors. Advances in molecular genetics have helped elucidate many of the gene defects. Nevus sebaceous is specifically addressed, as there has been much controversy regarding its treatment. Several benign tumors seen in the pediatric population can appear clinically suspicious for a malignancy: pseudorheumatoid nodules, pilomatrixoma, infantile myofibromatosis, and congenital smooth muscle hamartoma. Careful history and physical examination can enable dermatologists to reassure parents and patients of the benign nature of these lesions, obviating any need for further invasive testing. Comparatively, malignant lesions that may simulate benign lesions, metastatic cutaneous neuroblastoma, primary subcutaneous rhabdomyosarcoma, and other rare tumors, are addressed. Finally, clinical presentations of pediatric basal cell carcinoma and melanoma, although rare in this population, are discussed.