Derm Dx: Flesh-Colored Growth on the Cheek

Sebaceous gland hyperplasia is a benign proliferation of the sebaceous glands.1 Patients with this condition may describe asymptomatic, yellow, shiny bumps on the forehead, cheeks, or near the hair line. Characteristically these lesions are dome-shaped papules with a central umbilication.2...

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Sebaceous gland hyperplasia is a benign proliferation of the sebaceous glands.¹ Patients with this condition may describe asymptomatic, yellow, shiny bumps on the forehead, cheeks, or near the hair line. Characteristically these lesions are dome-shaped papules with a central umbilication.² Lesions can occur throughout the integument but most commonly arise on areas of photodamage on the chest, upper neck, and face in middle-aged and elderly people.¹ Several variants of sebaceous hyperplasia have been reported including familial form, giant form of 10 mm in diameter, and those in a linear arrangement.³ The underlying pathologic mechanism is unknown; however, lesion formation is associated with ultraviolet irradiation, advanced age, and immunosuppressive therapy. Treatment with cyclosporine alone or in combination with corticosteroids may induce lesion formation.³

Lesions typically appear as a pink-to-white firm papule ranging from 5 to 10 mm in diameter with sharp demarcated borders. The surface of the papules appear smooth and shiny.³ Dermatoscopy may help differentiate sebaceous hyperplasia from other disorders such as molluscum contagiosum, sebaceous carcinoma, sebaceous adenoma, and basal cell carcinoma.¹ Dermatoscopic examination reveals yellowish-white clods or lobules with linear vessels between or above the clods exhibiting a reticular distribution.³ Shave biopsy with histopathologic examination can rule out basal cell carcinoma and establish the diagnosis of sebaceous hyperplasia.^2,3

Current therapies used for treatment include bichloroacetic acid, cryotherapy, shave excision, electrodessication, and laser ablation.¹ In refractory cases, oral isotretinoin has been shown to be effective.⁴

References

1. Hogan D, Mohammad S. Sebaceous hyperplasia. Expert Rev Dermatol. 2011;6(1):91-96.
2.  Higgins JC, Maher MH, Douglas, MS. Diagnosing common benign skin tumors. Am Fam Physician. 2015;92(7):601-607.
3. Sato T, Tanaka M. Linear sebaceous hyperplasia on the chest. Dermatol Pract Concept. 2014;4(1):93-95.
4. Yu C, Shahsavari M, Stevens G, Liskanich R, Horowitz D. Isotretinoin as monotherapy for sebaceous hyperplasia. J Drugs Dermatol. 2010;9(6):699-701.