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Sebaceous Hyperplasia Clinical Presentation

  • Author: Daniel J Hogan, MD; Chief Editor: William D James, MD  more...
 
Updated: Jun 18, 2015
 

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 facial 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.[24, 25, 26, 27]

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Causes

Facial papular 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.

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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, Canadian Dermatology Association

Disclosure: Nothing to disclose.

Coauthor(s)

Stephen H Mason, MD 

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

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Steven R Feldman, MD, PhD Professor, Departments of Dermatology, Pathology and Public Health Sciences, and Molecular Medicine and Translational Science, Wake Forest Baptist Health; Director, Center for Dermatology Research, Director of Industry Relations, Department of Dermatology, Wake Forest University School of Medicine

Steven R Feldman, MD, PhD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, North Carolina Medical Society, Society for Investigative Dermatology

Disclosure: Received honoraria from Amgen for consulting; Received honoraria from Abbvie for consulting; Received honoraria from Galderma for speaking and teaching; Received consulting fee from Lilly for consulting; Received ownership interest from www.DrScore.com for management position; Received ownership interest from Causa Reseasrch for management position; Received grant/research funds from Janssen for consulting; Received honoraria from Pfizer for speaking and teaching; Received consulting fee from No.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Arash Taheri, MD Research Fellow, Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine

Disclosure: Nothing to disclose.

Acknowledgements

R Walker Jones, MD Harris M Blackman, MD, LLC

R Walker Jones, MD 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.

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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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