Sebaceous Hyperplasia

Excerpt

Sebaceous gland hyperplasia (SGH) is a benign and common condition of sebaceous glands.

SGH affects adults of middle age or older, mainly males. It reportedly occurs in approximately 1% of the healthy population. Sebaceous hyperplasia is not rare in newborns: an Iranian prospective cohort study reported that 43.7% of 1000 consecutive neonates examined had sebaceous hyperplasia; its appearance in that situation is transient and results from exposure to maternal hormones. It is uncommon during childhood and adolescence. It has been described in patients on chronic immunosuppressive therapy: reports of the prevalence of SGH are as high as 10 to 16% in patients treated for long-period with cyclosporine A. It has also been associated with genetic syndromes, in rare cases of Muir-Torre. In general, sebaceous adenomas more strongly correlate with that syndrome, and sebaceous hyperplasias are common in patients without any underlying condition.

Sebaceous glands have acini attached to an excretory duct; the production of sebum occurs inside the sebocyte, which accumulates lipids during its life cycle and then releases its content inside the principal excretory duct. Sebaceous glands are androgen-sensitive, so their activity differs according to circulating hormone levels and age. Sebaceous hyperplasia is composed of normally-looking glands with an increased number of acini and mature sebocytes.

The primary differential diagnoses include sebaceous adenoma, nevus sebaceus, lupus miliaris disseminatus faciei, and basal cell carcinoma.

Treatment for sebaceous hyperplasia is usually not needed but can merit consideration when it becomes a cosmetic issue or if it is clinically confused with a more concerning lesion. Various treatments are available for this condition, including cryotherapy or cryosurgery, photodynamic therapy, laser treatment (argon, carbon dioxide, or pulsed-dye laser), cauterization, or electrodesiccation shaving or excision, topical treatments with chloroacetic or trichloroacetic acid, and systemic treatment with isotretinoin.