Nevus lipomatosus superficialis on the face

A 17‐year‐old woman presented with asymptomatic, multiple plaques around the right mandibular area of the face extending from the cheek to the neck. These lesions had gradually increased in size and number for 8 years, and then were stationary. When she came to us, there were a few skin‐colored or pale yellowish papules and plaques ranging from 0.2 to 1 cm in diameter (Fig. 1). The patient stated that initially the papules developed discretely, and then these papules were confluent and grouped slowly with new lesions. The most recent lesions were skin‐colored papules which were soft to the touch, the older lesions were yellowish plaques with firm consistency and a smooth shiny surface. The patient's general condition had been good at the initial visit and the laboratory findings including blood cell counts, urinalysis, and routine blood chemistry tests were all within normal limits. A roentgenogram of the mandibular area did not reveal any significant findings. The presumptive clinical diagnosis of connective tissue nevus was made. Histologic examination of biopsy specimen taken from the neck showed lobules of fat cells embedded among the collagen bundles at the level of papillary dermis and collagen bundles were proliferated irregularly (Fig. 2). The individual fat cells were mature and of normal size. The lobules were not encapsulated and did not communicate with the subcutaneous fat tissue. The epidermal changes of the lesions consisted of mild hyperkeratosis with follicular plugging and slightly increased numbers of capillaries were observed around the dermal fat cells (Fig. 3). Therefore, it was diagnosed as nevus lipomatosus superficialis (NLS) which developed multiple lesions very rarely on the face. After surgical removal of the lesion, no evidence of recurrence has been observed 1 year postoperatively.