Pathology of Sebaceous Hyperplasia

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Dermpath-India

Dr Sampurna Roy MD 2022

Dermatopathology Quiz Case: 229

Answer - Sebaceous Hyperplasia

Sebaceous hyperplasia is a common benign lesion of the sebaceous gland.

This lesion has been seen in heart transplant and bone marrow recipients and is probably due to the effects of Cyclosporine.

Clinical presentation:

Solitary or multiple yellowish, umbilicated papules (1 to 3 mm in diameter).

Usually occurs in middle aged patients, but cases have been reported in younger individuals.

Juxtaclavicular beaded line - variant of sebaceous hyperplasia characterized by papules arranged in parallel rows resembling 'strands of beads'.

Site: Face, forehead, chest, areola, mouth, vulva etc.

Microscopic features:

Histology shows separate hyperplastic sebaceous glands ; mature sebaceous lobules connect to a central dilated duct ; essentially normal cytological appearance.

Lobules consist of :

(i) Basaloid or cuboidal cells without lipid droplets.

(ii) Layers of mature sebocytes with abundant lipid and scalloped nuclei.

Differential diagnosis:

Nevus sebaceus (lobules are aberrant, ducts open into the epidermis, there is epidermal hyperplasia and in some cases apocrine glands)

Rhinophyma (sebaceous glands are not as well defined and grouped as in sebaceous hyperplasia).