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
L73.8 – Other specified follicular disorders
238748009 – Sebaceous hyperplasia
Differential Diagnosis & Pitfalls
- Milia – Primary differential in sebaceous hyperplasia of the newborn. Also common in middle-aged adults and older. Tend to be smoother and smaller yellow / white papules without central dell.
- Dermal nevus (see common acquired nevus) – Intradermal nevi tend to be more skin colored, and there is no lobularity or central umbilication.
- Flat wart – Not as limited to the facial and genital areas as typical sebaceous hyperplasia.
- Fibrous papule
- Fordyce spots (visible, prominent sebaceous glands of mucosa)
- Basal cell carcinoma – Best differentiated with magnified examination (dermoscopy): small clusters of gland structures surrounding the follicle are not seen, and telangiectactic vessels (arborizing) tend to occur freely over the surface, as contrasted to the more peripheral "crown" vessels of sebaceous hyperplasia lesions.
- Molluscum contagiosum (adult, child) – May also be seen in the face and genitals; firm papular lesions are more exophytic and pearly with a core at the summit. (Enhance visualization of core with light liquid nitrogen freeze.)
- Xanthoma (eg, eruptive xanthoma)
- Calcifying epithelioma of Malherbe
- Lupus miliaris disseminatus faciei
- Rhinophyma – Unique rosacea-associated sebaceous hyperplasia of the nose.
- Colloid milium
Drug Reaction Data