Sebaceous Hyperplasia Clinical Presentation

  • Author: Daniel J Hogan, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 12, 2012
 

History

Patients may be concerned for cosmetic reasons or may be worried about possible malignancy.

  • Lesions are usually described as asymptomatic, soft, discrete, and yellow, with a surface that ranges from smooth to slightly verrucous.
  • Patients may report one or multiple lesions at various locations on the face.
  • Lesions may become red and irritated and bleed after scratching, shaving, or other trauma.
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Physical

Sebaceous hyperplasia is often found incidentally upon examination.

  • The classic appearance of sebaceous hyperplasia on physical examination reveals whitish-yellow or skin-colored papules that are soft and vary in size from 2-9 mm. These papules have a central umbilication from which a very small globule of sebum can sometimes be expressed.
  • Some papules may be associated with characteristics similar to basal cell carcinoma, such as telangiectasia.
  • Dermoscopy may be useful as a noninvasive tool to aid in the clinical diagnosis and in distinguishing between nodular basal cell carcinoma and sebaceous hyperplasia, reducing unnecessary surgery.[23, 24, 25, 26]
  • They are almost always located on the nose, cheeks, or forehead. They are occasionally located on the chest, upper arms, areolae, oral mucosa, and vulva.
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Causes

Sebaceous hyperplasia is thought to be caused by a decrease in the circulating levels of androgen associated with aging. Ultraviolet radiation and immunosuppression have been postulated as cofactors in causing sebaceous hyperplasia. Ultraviolet radiation is considered only a cofactor, because sebaceous hyperplasia occasionally occurs on areas of the body where sunlight is not a relevant issue, including the buccal mucosa, areolae, and vulva.

  • A decrease in circulating androgen results in a change in the rate sebocytes migrate from their points of differentiation into the sebaceous unit.
  • Sebocytes in hyperplastic glands are actually smaller than the average sebocytes in normal glands; the nuclei are larger and less accumulation of cytoplasmic lipid occurs.
  • The gland is enlarged, with a widened sebaceous duct and an increased number of basal cells.
  • Epithelial changes overlying dermatofibromas are well recognized. Two patients with sebaceous hyperplasia overlying a dermatofibroma have been reported.[27, 28]
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Contributor Information and Disclosures
Author

Daniel J Hogan, MD  Clinical Professor of Internal Medicine (Dermatology), Nova Southeastern University College of Osteopathic Medicine; Investigator, Hill Top Research, Florida Research Center

Daniel J Hogan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, and Canadian Dermatology Association

Disclosure: Nothing to disclose.

Coauthor(s)

R Walker Jones  Louisiana State University Health Sciences Center

R Walker Jones is a member of the following medical societies: American Chemical Society, American Medical Association, American Medical Student Association/Foundation, and Louisiana State Medical Society

Disclosure: Nothing to disclose.

Stephen H Mason  MD

Stephen H Mason is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American Society for Dermatologic Surgery, Skin Cancer Foundation, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

David P Fivenson, MD  Associate Director, St Joseph Mercy Hospital Dermatology Program, Ann Arbor, Michigan

David P Fivenson, MD is a member of the following medical societies: American Academy of Dermatology, Medical Dermatology Society, Michigan Dermatological Society, Michigan State Medical Society, Photomedicine Society, Society for Investigative Dermatology, and Wound Healing Society

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD  Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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Normal sebaceous gland histology. Courtesy of Cooper Heard, MD.
Histology of sebaceous hyperplasia; enlarged sebaceous gland with multiple lobules grouped around a central dilated sebaceous duct. Courtesy of Cooper Heard, MD.
 
 
 
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