Nevus Sebaceus With Novel HRAS Sequence Variant Mutation Misdiagnosed As Alopecia Areata

    May 2023 in “ Cutis ”
    Donald J Fernandes
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    TLDR A 12-year-old girl was misdiagnosed with alopecia areata but actually had a nevus sebaceus with a genetic mutation.
    A 12-year-old girl initially misdiagnosed with alopecia areata was later found to have a nevus sebaceus (NS) with a novel HRAS sequence variant mutation. Despite treatment with topical corticosteroids and minoxidil, her condition did not improve. Physical examination revealed a well-demarcated, yellowish-pink plaque on her scalp, which was bald but contained fine vellus hairs. A biopsy confirmed the presence of NS with incidental compound nevus, and genetic testing identified a missense HRAS p.G12V variant. The case highlights the importance of accurate diagnosis in congenital scalp lesions.
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