Indian Journal of Dermatology
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CASE REPORT
Year : 2007  |  Volume : 52  |  Issue : 2  |  Page : 102-103
Sebaceous hyperplasia mimicking lymphangioma


1 Department of Pathology, JJM Medical College, Davangere - 577 004, Karnataka, India
2 Department of Dermatology, JJM Medical College, Davangere - 577 004, Karnataka, India

Correspondence Address:
P Shashikala
Department of Pathology, JJM Medical College, Davangere - 577 004
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.33289

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   Abstract 

Sebaceous hyperplasia of forehead, presenting as pin-sized translucent vesicles in a young girl is presented. The lesion was clinically mistaken for lymphangioma circumscriptum. Microscopic examination of punch biopsy of skin helped to arrive at a proper diagnosis.


Keywords: Lymphangioma, sebaceous hyperplasia


How to cite this article:
Kumar P, Shashikala P, Kumar J, Chandrasekhar H R. Sebaceous hyperplasia mimicking lymphangioma. Indian J Dermatol 2007;52:102-3

How to cite this URL:
Kumar P, Shashikala P, Kumar J, Chandrasekhar H R. Sebaceous hyperplasia mimicking lymphangioma. Indian J Dermatol [serial online] 2007 [cited 2020 Feb 25];52:102-3. Available from: http://www.e-ijd.org/text.asp?2007/52/2/102/33289



   Introduction Top


Sebaceous hyperplasia is a benign dermatosis characterized by asymptomatic solitary or multiple lesions on the face, with a predilection for forehead and rarely oral cavity. Lesions are common in middle-aged persons and occurs rarely in early adult life. We report a case of sebaceous hyperplasia (a) because of its rarity of occurrence in second decade of life and (b) clinical picture masquerading as lymphangioma circumscriptum.


   Case Report Top


A 17-year-old girl presented with skin lesions in the forehead, which was present since two years. There was no history of pain or itching. The lesions had an insidious onset and progressed gradually. On examination, there were multiple pinhead-sized translucent grouped vesicles over the forehead. With a clinical diagnosis of lymphangioma circumscriptum, a punch biopsy was done.

Microscopic examination of the biopsy showed epidermis, which was unremarkable. There was a single greatly enlarged sebaceous gland composed of numerous lobules around a branching sebaceous duct opening in to the epidermis. Lobules of sebaceous glands appeared fully mature [Figure - 1].


   Discussion Top


Clinically, sebaceous hyperplasia presents as single or multiple yellow papules or skin nodules, usually 0.2 to 0.3 cm in diameter with central area of umbilication. [1],[2] Central umbilication helps in distinguishing it from basal cell carcinoma. [3]

It is common in middle-aged persons and occurs rarely in early adult life. [1],[4] Our patient was young and presentation at this age is unusual.

The presence of a clinical lesion on skin is a prerequisite for the diagnosis of sebaceous hyperplasia. [1],[5] This is necessary because large sebaceous glands that do not produce a papule would not be clinically evident because of the keratinization and pigmentation of the overlying skin, but oral cavity is an exemption because even normal sebaceous glands are clinically obvious under the non keratinized, usually nonpigmented epithelium of the buccal mucosa.

A discrete yellow papule or nodule, clinically resembles a number of lesions like Fordyce granules, sebaceous adenoma, nevus sebaceous of Jadossohn, inflammatory hyperplastic lesions, mucous retention phenomenon, hemangioma, benign or malignant mesenchymal lesions. [6],[7]

According to Daley's criteria for diagnosis of sebaceous hyperplasia, one or more well differentiated sebaceous glands exhibiting not less than 15 lobules per gland should be present. [6],[7]

Microscopically, sebaceous adenoma can be distinguished from sebaceous hyperplasia by the presence of both mature sebaceous cells and small germinative cells arranged in an irregular pattern lacking dilated excretory duct or common excretory duct. [7]

 
   References Top

1.Elder D, Elenitsas R, Ragsdale BD. Tumors of the epidermal appendages. In: Elder D, editor. Lever's Histopathology of the skin. 8 th ed. Lippincott-Raven: New York; 1997. p. 765-6.  Back to cited text no. 1      
2.Kudoh K, Hosokawa M, Miyazawa T, Tagami H. Giant solitary sebaceous gland hyperplasia clinically simulating epidermoid cyst. J Cutan Pathol 1988;15:396-8.  Back to cited text no. 2  [PUBMED]    
3.Czarnecki DB, Dorevitch AP. Giant senile sebaceous hyperplasia. Arch Dermatol 1986;122:1101.  Back to cited text no. 3  [PUBMED]    
4.Burton CS, Sawchauk WS. Premature sebaceous gland hyperplasia, successful treatment with isotretinoin. J Am Acad Dermatol 1985;12:182-4.  Back to cited text no. 4      
5.Prioleau PG, Santa Oruz DJ. Sebaceous gland neoplasia. J Cutan Pathol 1984;11:396-414.  Back to cited text no. 5      
6.Daley TD. Intraoral sebaceous hyperplasia. Diagnostic criteria. J Oral Surg Oral Med Oral Pathol 1993;75:343-7.  Back to cited text no. 6      
7.Dent CD, Hunter WE, Svirsky JA. Sebaceous gland hyperplasia: Case report and literature review. J Oral Maxillofac Surg 1995;53:936-8.  Back to cited text no. 7  [PUBMED]  [FULLTEXT]  


    Figures

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