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Sebaceous adenoma - Skin
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Sebaceous adenoma - Skin

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Contributors: Alexa Kimball MD, Jeffrey D. Bernhard MD, Belinda Tan MD, PhD, Noah Craft MD, PhD, Lindy P. Fox MD, Lowell A. Goldsmith MD, MPH, Michael D. Tharp MD
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Synopsis

Sebaceous adenomas are benign neoplasms that derive from sebaceous glands. They can be a marker for Muir-Torre syndrome. Sebaceous glands are located everywhere that hair is found, as they are associated both structurally and embryologically with the hair sheath. Sebaceous lesions are most commonly present over the head and neck, which is where sebaceous glands are particularly abundant.

Though considered rare, the actual incidence of sebaceous adenomas is unknown. There is no racial predilection or increased incidence in a particular geographical location. Sebaceous adenomas frequently appear after the age of 50, with an average age of onset of 60. They typically affect men and women equally. These benign neoplasms do not have the potential for aggressive growth or metastasis, though local recurrence may occur after incomplete removal of the tumor.

Patients experience the gradual onset of small (approximately less than 5 mm), smooth, well-circumscribed, speckled yellow papules, most commonly on the central face, scalp, or neck. Though less common, sebaceous adenomas may also present throughout other hair-bearing areas of the body, including the trunk and the legs. Possible symptoms include bleeding and pain and, less commonly, ulceration. Lesions can be single or multiple. Less frequently, a sebaceous adenoma may have central umbilication or present as tan or pink to red papules.

Predisposing medical history and risk factors:
Muir-Torre syndrome (MTS) is an autosomal dominant condition characterized by the presence of sebaceous neoplasms and internal malignancy. The criteria for this syndrome include either:
  • The concurrent or sequential development of a sebaceous neoplasm, including sebaceous adenoma, and an internal malignancy, or
  • The presence of multiple keratoacanthomas and an internal malignancy, with a family history of MTS.
MTS results from a germline mutation in a DNA mismatch repair gene, commonly MSH2, and it follows autosomal dominant inheritance. It has been reported that sebaceous tumors, including sebaceous adenomas, are a marker for the mismatch repair gene-deficient subtype of MTS and are associated with a high risk for developing internal malignancies later in life. The internal malignancies associated with MTS do have the potential to metastasize.

Codes

ICD10CM:
D23.9 – Other benign neoplasm of skin, unspecified

SNOMEDCT:
307598005 – Sebaceous adenoma of skin

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Sebaceous gland hyperplasia – small yellow papule with central umbilication (sebaceous adenomas   demonstrate umbilication less frequently). A small globule of sebum can be expressed from   the umbilicated opening in sebaceous hyperplasia. Additionally, dermatoscopy reveals overlying telangiectasias (often seen in sebaceous gland hyperplasia but not found in sebaceous adenomas). 
  • Sebaceous carcinoma – found on eyelid half of the time; histology shows dermal aggregates of atypical, poorly differentiated polyhedral tumor cells separated by fibrovascular stroma
  • Sebaceous epitheliomas – greater than 50% of cells are of smaller, germinative basaloid type
  • Basal cell carcinoma
  • Sebaceoma
  • Nevus sebaceus
  • Sebocrine adenoma

Best Tests

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Therapy

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References

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Last Updated: 02/08/2016
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Sebaceous adenoma - Skin
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Sebaceous adenoma : Cheek, Forehead, Neck, Scalp, Smooth papule, Yellow color
Clinical image of Sebaceous adenoma
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