II. Epidemiology
- Onset in middle age
- Rarely occurs at Puberty in familial forms
- Intraoral Sebaceous Hyperplasia (Fordyce Spots) are seen in 1% of newborns
III. Pathophysiology
- Composed of mature, enlarged Sebaceous Glands with dilated duct
IV. Causes
- Most cases idiopathic with aging
- Cyclosporine
- Hemodialysis
V. Signs
- Characteristics
- Pale yellow color
- Soft, shiny dome-shaped Papules
- May be centrally umbilicated
- Usually 2-4 mm in size
- May appear
-
Dermoscopy
- Cauliflower-like multiple yellow lobules surrounding Hair Follicles
- Distribution
- Forehead, Cheeks, Nose
- Vulva
VI. Labs
- Biopsy only lesions suspicious for Basal Cell Carcinoma
VII. Differential Diagnosis
-
Basal Cell Carcinoma
- Basal cell is typically more red or pink than the yellow Sebaceous Hyperplasia
-
Surface vessels are haphazardly positioned (under magnification)
- Contrast with inter-lobular vessels only in Sebaceous Hyperplasia
VIII. Management
- Biopsy if suspect Basal Cell Carcinoma
- Cosmetic removal
- Shave excision
- Electrodesiccation
- Cryosurgery
- Laser ablation
- Topical bichloracetic acid
- Avoid curettage due to scarring
- Multiple lesions have been treated with Accutane (oral Isotretinoin)
IX. References
- Habif (1996) Dermatology, Mosby, p. 646-7
- Higgins (2015) Am Fam Physician 92(7): 601-7 [PubMed]
- Luba (2003) Am Fam Physician 64(3):729-38 [PubMed]
- Wagner (2024) Am Fam Physician 110(4): 353-61 [PubMed]