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Tumors of Cutaneous Appendages
Published in Omar P. Sangueza, Sara Moradi Tuchayi, Parisa Mansoori, Saleha A. Aldawsari, Amir Al-Dabagh, Amany A. Fathaddin, Steven R. Feldman, Dermatopathology Primer of Cutaneous Tumors, 2015
Sebaceous adenoma: More than two cell layers of germinative epithelium
Sebaceous tumors
Published in Longo Caterina, Diagnosing the Less Common Skin Tumors, 2019
Sebaceous tumors are uncommon entities that include sebaceous adenoma, sebaceoma (sebaceous epithelioma) and sebaceous carcinoma.1,2 Sebaceous adenoma and sebaceoma are very similar at clinical presentation, appearing as slow-growing, flesh-colored solitary papules, mainly located on the head and neck region and generally involving elderly patients. Multiple forms in younger individuals are commonly seen in the context of the Muir–Torre syndrome. Multiple sebaceous carcinomas may also be seen in patients with Muir–Torre syndrome. Generally, this malignant tumor involves the ocular adnexa, particularly the meibomian and Zeis glands. Less commonly extraocular sites are involved; in these cases, sebaceous carcinoma appears as a yellowish firm papule, from 1 to 4 cm in diameter, often ulcerated and is more frequently seen on the head and neck of elderly patients.3 On histopathologic examination, sebaceous adenoma appears as a dermal mass composed by sebaceous lobules separated by connective tissue septa. Darker germinative cells may be seen at the periphery of the lobules while paler mature cells are located in the central part. In sebaceoma multiple dermal nests are instead commonly seen, which are mainly composed of small basaloid cells with some mature sebaceous cells. Concerning sebaceous carcinoma, sheets or lobules of cells are commonly seen, which extend from the dermis to the subcutis and even to the underlying muscle.4 Muir–Torre syndrome (Online Mendelian Inheritance in Man [OMIM] 158320) is an autosomal dominant disease and represents an allelic variant (accounting for 1%–2% of cases) of the hereditary nonpolyposis colon syndrome (Lynch syndrome). Mutations in some DNA mismatch repair genes have been demonstrated to cause Muir–Torre syndrome, being MSH2, MLH1 and MSH6 the most implicated. Mutations in these genes are associated with microsatellite instability that characterizes tumors associated with this syndrome. Muir–Torre syndrome is characterized by the development of sebaceous tumors in association with visceral neoplasms, most commonly gastrointestinal carcinomas. Other cutaneous findings may be keratoacanthomas and epidermal cysts. When sebaceous tumors are multiple and/or occur before the age of 50 years, Muir–Torre syndrome should always be suspected.5
Dermatological indications for the use of isotretinoin beyond acne
Published in Journal of Dermatological Treatment, 2018
Emily Forbat, Faisal R. Ali, Firas Al-Niaimi
A randomized comparative trial comparing alternate daily use of 10 mg isotretinoin versus topical anti-seborrheic treatment in moderate to severe seborrhea and seborrheic dermatitis (N = 45) over 6 months, demonstrated a significantly greater reduction in scalp sebum secretion (p = .004) in the isotretinoin arm after 3 months (47). Patients were not followed-up beyond 3 months and the dosage was not weight-dependent. Tagliolatto et al. treated 20 patients with sebaceous hyperplasia with isotretinoin (1 mg/kg per day) for 2 months; the average number of skin lesions decreased from 24 to 2 per patient (p < .05) (59). Isotretinoin is beneficial in sebaceous hyperplasia and sebaceous adenoma (7), cyclosporine-induced sebaceous hyperplasia in renal transplant (15,23), and diffuse familial sebaceous hyperplasia (14).
Treatment of sebaceous gland hyperplasia: a review of the literature
Published in Journal of Dermatological Treatment, 2021
SGH is a unique cutaneous side effect of ciclosporin, occurring exclusively in male transplant recipients (5). De Berker et al. (7) reported that 16 of 104 (16%) heart transplant recipients had SGH compared to only 1% of age-and sex-matched control group not taking immunosuppressive medications. Clinically, SGHs are typically singular or multiple soft yellow 2–3 mm in size papules with smooth surface and central umbilication.They arise from a dilated excretion duct and are predominantly apparent on the forehead, nose and cheeks but can present on other areas of the body (1,2,5,8). Biopsy may be required to differentiate SGH from sebaceous nevus, sebaceous adenoma, sebaceous epithelioma, basal cell carcinoma, molluscum contagiosum and xanthoma (8).