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Sebaceous hyperplasia
Other Resources UpToDate PubMed

Sebaceous hyperplasia

Contributors: David O'Connell MD, Sarah Hocker DO, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Sebaceous hyperplasia is not a true neoplasm but rather the result of localized hypertrophy of the sebaceous glands. Sebaceous hyperplasia usually occurs on the central face, most prominently the forehead. It presents as solitary or, more often, multiple skin-colored to yellow papules of 2-5 mm (or more) that usually exhibit a central dell corresponding to the patulous follicular infundibulum. A peripheral "crown" of telangiectatic vessels is often observed with dermoscopy.

Classically, sebaceous hyperplasia affects middle-aged to older adults, where it is seen in more than 25% of individuals. It also has been noted to rarely occur in the peripubertal and young adult age group, often in a familial pattern.

Sebaceous hyperplasia may also be present on the nipples, where it is referred to as Montgomery's tubercles, and on anogenital regions of the foreskin, penile shaft, scrotum, and vulva, where the differential diagnosis would include molluscum contagiosum and human papillomavirus (HPV).

Juxtaclavicular beaded lines (JCBL) is a unique presentation of sebaceous hyperplasia presenting as small (0.5-1.5 mm), slightly yellow papules in a linear pattern occurring in lines of cleavage localized to the low neck and juxtaclavicular areas. Unlike classic sebaceous hyperplasia, this condition presents earlier in life, starting during or just after puberty.

Sebaceous hyperplasia is seen in up to 30% of renal transplant patients receiving cyclosporin as immunosuppression and is also reported to affect heart and hematopoietic stem cell transplant recipients. Recently, the related immunosuppressant tacrolimus has been associated with the development of sebaceous hyperplasia as well.

Sebaceous hyperplasia is benign, and treatment is for cosmetic purposes, although, in rare cases, eruptions can be severe and disfiguring.

Related topic: Sebaceous hyperplasia in newborn

Codes

ICD10CM:
L73.8 – Other specified follicular disorders

SNOMEDCT:
238748009 – Sebaceous hyperplasia

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

For anogenital lesions, also consider condyloma acuminatum.

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:12/15/2019
Last Updated:01/23/2020
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Patient Information for Sebaceous hyperplasia
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Contributors: Medical staff writer

Overview

Sebaceous hyperplasia is a common harmless enlargement of the skin oil glands.

Who’s At Risk

It usually occurs in middle-aged and older adults and is seen in about 1% of the US population.

About 10-16% of people on long-term cyclosporin A for organ transplants also develop sebaceous hyperplasia. There are a few families where multiple lesions begin to occur during puberty.

Signs & Symptoms

Lesions may be single or multiple. They are seen in areas where many oil glands are found - the face (nose, cheeks, and forehead), chest, upper arms, mouth lining, vulvar area, and around the nipples.

They are small (2-9 mm), painless, whitish-yellow-to-pink or skin-colored bumps, often with a central depression or dimple.

Self-Care Guidelines

No treatment is required. They will not go away on their own.

When to Seek Medical Care

See your doctor:
  • If the lesions are irritated (by shaving, glasses, or clothing) or if they are cosmetically bothersome.
  • If you have many lesions (over 10) or if they are growing or bleeding.

Treatments

If there is doubt about the diagnosis, a biopsy may be done.

Many types of treatment can remove the lesions, with a small risk of leaving scars:
  • Burning (cautery)
  • Freezing (cryosurgery)
  • Applying topical chemicals
  • Applying a drug activated by light (photodynamic therapy)
  • Laser treatment
  • Cutting out the lesions (excision)

References


Bolognia, Jean L., ed. Dermatology, pp.546-547, 1743. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed. pp.2541. New York: McGraw-Hill, 2003.
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Sebaceous hyperplasia
A medical illustration showing key findings of Sebaceous hyperplasia : Cheek, Forehead, Nose, Temple
Clinical image of Sebaceous hyperplasia - imageId=325411. Click to open in gallery.  caption: 'A close-up of yellowish and pink umbilicated papules on the forehead.'
A close-up of yellowish and pink umbilicated papules on the forehead.
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