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Sebaceous carcinoma is a rare malignant skin neoplasm arising from sebaceous glands. Its clinical diagnosis is difficult and reports of dermoscopic findings have been limited. This study aims to analyze its dermoscopic features and differential diagnosis in dermoscopic examination. The study included patients diagnosed with histologically proven sebaceous carcinomas as well as diagnosed cases of sebaceous hyperplasia, sebaceoma, squamous cell carcinoma and basal cell carcinoma for comparison of dermoscopic findings. The dermoscopic criterion of presence of sebaceous carcinoma was scored only if the two evaluators reached a consensus. Fifteen cases of histologically diagnosed sebaceous carcinoma were included in our study. All cases were extraocular sebaceous carcinoma. A total of 60 (15 basal cell carcinomas, 15 squamous cell carcinomas, 15 sebaceous hyperplasias and 15 sebaceomas) cases were collected for comparing dermoscopic features with sebaceous carcinoma. In dermoscopic analysis of sebaceous carcinoma, the majority of tumors (66.67%) presented polymorphic vessel pattern. Other features included whitish-pink areas (80%), yellowish structures (73.33%) and yellowish structureless areas (60%). Yellowish structures in sebaceous carcinomas are the main dermoscopic findings to differentiate squamous cell and basal cell carcinomas (P < 0.001), whereas purplish globules, shiny white blotches and strands and whitish-pink area distinguish sebaceous carcinomas from other sebaceous tumors (P < 0.05).

Introduction Reliable nuclear immunohistochemical stains for sebaceous neoplasms have not been readily available. Positive nuclear staining has been reported by GATA3 and factor XIIIa (AC-1A1). We sought to determine the diagnostic utility of these nuclear stains by comparing their staining pattern to adipophilin, a consistently positive cytoplasmic stain. Methods Cases with the diagnosis of sebaceous hyperplasia, sebaceous adenoma, sebaceous epithelioma/sebaceoma, and sebaceous carcinoma, nonsebaceous neoplasms (basal cell carcinoma, and squamous cell carcinoma) were examined. Intensity and extent of staining of the basal cells and mature sebocytes were evaluated for each stain. Results Factor XIIIa (AC-1A1) was 87.3% sensitive for all sebaceous neoplasms and 95.1% specific and demonstrated high inter-observer reliability. Adipophilin was 83.2% sensitive and 87.8% specific. GATA3 was the least sensitive (80.9%) and specific (75.6%) marker. When factor XIIIa was compared against composite staining of all three markers its staining was still uniquely significant (p = 0.0210). Conclusion Factor XIIIa (AC-1A1) is a sensitive and specific nuclear marker for sebaceous differentiation. Its diagnostic utility exceeds that of adipophilin. Factor XIIIa should be included in the expanding group of immunohistochemical and special stains which can be utilized to aid in the diagnosis of sebaceous neoplasms.

Background Sebaceous proliferations are common and may be confused with other cutaneous neoplasms. Few useful or specific immunohistochemical markers for sebaceous differentiation are available. We incidentally observed strong factor XIIIa (Ventana clone AC-1A1 on Ventana Benchmark Ultra stainer) nuclear staining in normal sebaceous glands and hypothesized that this might be a useful marker in sebaceous proliferations. Methods Immunohistochemistry for factor XIIIa (AC-1A1) was performed on seven sebaceous hyperplasias, eight sebaceous adenomas, five sebaceomas, seven sebaceous carcinomas. Results Strong nuclear factor XIIIa (AC-1A1) staining was present in 100% of normal sebaceous glands, 100% of sebaceous hyperplasia, adenoma and carcinoma, and 80% of sebaceoma. Moderately or poorly differentiated squamous cell carcinomas (SCCs) (n = 26) were also stained for factor XIIIa (AC-1A1); two showed focal strong staining (8%), but the remainder showed only weak or negative staining (92%). In contrast, factor XIIIa clones from Abcam, Cambridge, MA, USA (EP3372) and Vector Laboratories, Burlingame, CA, USA (E980.1) were negative in sebocyte nuclei. Conclusions We report the novel finding of consistent nuclear factor XIIIa (AC-1A1) staining in normal, hyperplastic and neoplastic sebocytes. Factor XIIIa (AC-1A1) is a highly sensitive marker of sebaceous differentiation. It may have potential clinical utility as a specific marker to distinguish sebaceous carcinoma from poorly differentiated SCC.

Sebaceous carcinoma is a rare but serious malignancy that may be difficult to diagnose when poorly differentiated. Other epithelial tumors with clear cell change may mimic sebaceous carcinoma. Few useful or specific immunohistochemical markers for sebaceous differentiation are available. Nuclear staining with factor XIIIa (clone AC-1A1) was recently found to be a highly sensitive marker of sebaceous differentiation. We evaluated nuclear factor XIIIa (AC-1A1) staining in sebaceous neoplasms vs. other cutaneous clear cell tumors. We stained 27 sebaceous proliferations: sebaceous hyperplasia (7), sebaceous adenoma (8), sebaceoma (5), sebaceous carcinoma (7). We also stained 67 tumors with clear cell change: basal cell carcinoma (8), squamous cell carcinoma (8), hidradenoma (7), desmoplastic trichilemmoma (2), trichilemmoma (10), trichilemmal carcinoma (3), clear cell acanthoma (9), atypical fibroxanthoma (1), syringoma (8), trichoepithelioma (1), metastatic renal cell carcinoma (2), and nevi with balloon cell change (8). Nuclear factor XIIIa (AC-1A1) staining was present in 100% of sebaceous proliferations; 96% displayed strong staining. Non-sebaceous clear cell tumors were negative or only weakly positive with factor XIIIa (AC-1A1) in 95.5%; only 4.5% showed strong staining. This suggests that strong nuclear factor XIIIa (AC-1A1) staining is a sensitive and specific marker of sebaceous neoplasms vs. other clear cell tumors.

We present two cases of cyclosporine-induced sebaceous hyperplasia in renal transplant recipients, successfully treated with isotretinoin. Both patients tolerated isotretinoin well, with no alteration in graft function. These cases provide support for the safe and effective use of oral isotretinoin in the treatment of cyclosporine-induced sebaceous hyperplasia in the kidney transplant population.

The male nipple-areola-complex (NAC) is a residual organ without physiologic functions in the male. It possesses similar hormone sensitivity and sexual sensitivity as the female organ. The location of the NAC on the chest wall with respect to other surface features is relevant for the male appearance. All known disseminated skin diseases may involve the nipple and areola. A number of specific localized diseases have been described in the literature, such as mammillary eczema, demodicidosis, lymphadenosis cutis benigna, nevoid hyperkeratosis, and thelalgia. Special attention is required if nipple discharge is observed. Areolar sebaceous hyperplasia and nearly all kinds of benign cutaneous tumors occur on the nipple and areola. Malignant tumors such as basal cell carcinoma, melanoma, Paget disease and other forms of breast cancer may also be found. In addition, aberrant mammary tissue may occur with a broad clinical spectrum, while absence of the nipple is an unusual observation and occurs in rare syndromes. The association of aberrant mammary tissue with urinary tract malformations has not been confirmed.

Sebaceous neoplasia comprises a spectrum ranging from benign to malignant. Proper histological identification is important for treatment, prognosis and potential association with the Muir–Torre syndrome (MTS). Our increased understanding of the significance and pathogenesis of these tumours has led to improved risk stratification, screening recommendations, and treatment of patients with an initial presentation of a sebaceous tumour. This review focuses on the diagnostic and histological features of sebaceous lesions, the MTS, and recent insights into the molecular pathogenesis of sebaceous tumorigenesis.

Background: Recent studies have demonstrated telomerase expression in ophthalmologic sebaceous carcinoma and have suggested possible diagnostic utility in distinguishing these neoplasms from sebaceous adenomas. The aim of this study was to evaluate telomerase expression via human telomerase reverse transcriptase (hTERT) immunohistochemical staining in a spectrum of sebaceous lesions of the skin. Methods: Paraffin-embedded sections from sebaceous hyperplasia (11), nevus sebaceus (22), sebaceous adenoma (19), sebaceoma (11), and sebaceous carcinoma (14) were evaluated for intensity (0 to 3+) and pattern of anti-hTERT staining. Results: Strong (2 to 3+) hTERT staining was observed in nucleoli of germinative cells and immature sebocytes in all sebaceous lesions, whereas mature sebocytes were negative. The distribution pattern paralleled features seen by routine haematoxylin and eosin-stained sections. Conclusions: All hyperplastic and neoplastic sebaceous skin lesions expressed hTERT in this immunohistochemical study. The pattern of staining was predictive of the histologic pattern of the process but does not significantly add to our diagnostic armamentarium of sebaceous lesions.

BACKGROUND Neurofibromatosis, type 1, is associated with cutaneous melanin pigmentation, but an association with ordinary melanocytic nevi has not been described. METHODS This retrospective case-control study was designed to see if neurofibromas in patients with neurofibromatosis, type 1 (NF-1) differ from sporadic neurofibromas (SN) in their incidence of associated melanocytic nevi and other histologic features. Slides from 114 NF-1 were compared with 112 SN and 300 intradermal melanocytic nevi (IDN). RESULTS Small lentiginous melanocytic nevi were identified over 13 NF-1 (11%) but no SN (P=0.0002). Compared with other NF-1, NF-1 with nevi were more frequently associated with melanocytic hyperplasia, giant melanosomes and diffuse neurofibroma (P

WOS: 000331461700040 PubMed: 23829474 …

Background: Sebaceous gland neoplasms are rare tumors that are associated with visceral malignancies in patients with Muir–Torre syndrome (MTS). The majority of the MTS-associated tumors reveal mutations in DNA mismatch repair (MMR) genes (most often hMSH-2 and hMLH-1) and microsatellite instability. The sebaceous gland lesions in patients with MTS can often precede or occur concurrently with the visceral neoplasms. The early recognition of those lesions and their differentiation from sporadic sebaceous gland tumors are critical for proper patient management. Here we investigate the MMR gene expression in a variety of sebaceous gland tumors, with or without associated visceral malignancy. Methods: We studied the expressions of hMLH-1 and hMSH-2 in 10 consecutive sebaceous hyperplasias, 10 sebaceus nevi, 12 sebaceous adenomas, seven sebaceous carcinomas and the adjacent normal sebaceous glands using immunohistochemistry and paraffin-embedded sections. Results: The normal sebaceous glands and the glands of all the sebaceus nevi were positive for hMLH-1 and hMSH-2. Loss of hMSH-2 expression was found in 1/10 (10%) sebaceous hyperplasias, 3/12 (25.0%) sebaceous adenomas, and 2/7 (28.6%) sebaceous carcinomas. Loss of hMLH-1 expression was seen in 1/10 (10%) hyperplasias, 3/12 (25.0%) adenomas, and 1/7 (14.3%) carcinomas. No concurrent loss of both hMLH-1 and hMSH-2 was observed. Loss of MMR (either hMLH-1 or hMSH-2) was detected in 80% of the benign sebaceous lesions associated with malignancy. In comparison, only 23% of sebaceous lesions not associated with malignancy showed loss of MMR proteins. No loss of hMSH-2 protein was found in the visceral cancer in one patient with hMSH-2-negative sebaceous adenoma. Conclusions: Our results confirm the previous reports of alterations of mismatch repair genes in the sebaceous neoplasms of patients with MTS. However, we showed that those changes also occur early at the stage of sebaceous hyperplasia, even in the absence of a visceral malignancy. This indicates the importance of the abnormal DNA mismatch repair in the progression of this disease.

The clinical and histopathological features of 13 Persian cats which presented with chronic skin disease primarily affecting the face are described. Lesions were characterized by black material adherent to the skin and hair, accompanied by erythema and variable degrees of excoriation. Concurrent ceruminous otitis externa was observed in 7 cases. Histopathological examination of skin biopsy specimens showed marked acanthosis with crusting, hydropic degeneration and dyskeratotic basal epithelial cells, a mixed diffuse superficial inflammatory infiltrate and sebaceous hyperplasia. Malassezia pachydermatis yeasts and various bacteria were isolated from the lesions in some of the cats but in no case was antimicrobial therapy curative. The response to glucocorticoids was variable and often poor. No satisfactory therapeutic regimen could be identified and the cause of the disorder is unknown although a genetic basis is possible.

Summary Multiple clustered dermatofibroma is a very rare clinical variant of the dermatofibroma, and sebaceous differentiation overlying dermatofibromas is also unusual. We report the first case of a multiple clustered dermatofibroma with overlying sebaceous hyperplasia.

Introduction Sebaceous hyperplasia is a benign proliferation of the sebaceous gland. In this study, we tried to define the dermatoscopic features of sebaceous hyperplasia, which will help to minimize misdiagnoses. Material and method Seventeen patients with 30 sebaceous hyperplasia lesions were included in the study. All the lesions were evaluated dermatoscopically. Results Cumulus sign, crown vessels, and milia-like cysts were detected in 100%, 86.6%, 53.3% of the lesions, respectively. In 80% of the lesions, the bonbon toffee sign was detected. Conclusion During this study, we observed a feature with central umbilication surrounded by cumulus sign in 80% of our cases, and we named this entity as the ‘Bonbon toffee sign’, which resembled us ‘bonbon toffee’. We think the ‘bonbon toffee sign’ is a simple and easily recognizable phrase, and it can be used as a new terminology in dermatoscopic diagnosis of sebaceous hyperplasia.

Our objective was to study skin disorders in neonates within the first 48 hours of life in Ahvaz, Iran. One thousand consecutive neonates were examined in a descriptional prospective cohort study for 1 year (2002–03). The rate of skin disorders and their relationship to age of gestation and sex were calculated and analyzed using the computerized program spss version 10 and chi-squared test (χ2). Our findings were Mongolian spots (71.3%), Epstein pearls (70.2%), sebaceous hyperplasia (43.7%), salmon patch (26.2%), hypertrichosis (25.7%), erythema toxicum (11.1%), milia (7.5%), desquamation (1.9%), hemangioma (1.3%), and miliaria (1.3%). The most frequent skin disorders were Mongolian spots, Epstein pearls, and sebaceous hyperplasia. Differences between our study findings and those of others may be based on racial differences and study method.

Juxta-clavicular beaded lines (JCBL) are unique malformations of sebaceous glands or a variant of sebaceous hyperplasia with characteristic clinical features (1, 2). We describe a patient with JCBL, who received immunosuppressants following kidney transplantation. To our knowledge, our patient is the first case of JCBL in a kidney transplant recipient.

The face is known to be the most frequent site for sebaceous hyperplasia (SH); in fact, this particular pathology has rarely been reported in other sites, as for instance the areole. The first case of the areolar SH (ASH) was described in 1985 in a 37-year-old woman, presenting as bilateral diffuse thickening of the areolas. In the course of the years, few other cases of bilateral and unilateral ASH in both genders have been reported and all on histological samples. Herein, we describe the cytological aspects of unilateral ASH. To the best our knowledge, this is the first case diagnosed on cytoscraping of the nipple, subsequently confirmed histologically. A 50-year-old woman with painless yellowish plaques involving the left nipple (Fig. 1) was referred to our attention for a nipple scraping. The lesion had been noted 3 weeks before by the patient herself. The physical examination did not reveal neither any other similar lesions on the contra-lateral nipple nor any associated axillary lymphadenopathy. The clinical diagnosis was a possible nipple Paget disease. Nipple scraping was performed using a 4-mm dermatological curette after disinfection and without local anesthesia. From the material obtained, two smears were set up, fixed in alcohol, and stained with the Papanicolaou method. The smears appeared rich in cells arranged in either syncytial (flat) or cluster (tridimensional) squamous epithelial structures in a cleaned background. Closely associated with these squamous epithelial cell groups, there were large cells with finely vacuolated cytoplasm and small paracentral nuclei (Fig. 2a). The cytological report suggested “Possible Nipple Sebaceous Hyperplasia.” A biopsy was performed on the areola and the histopathological examination indeed revealed an areolar cutaneous fragment with numerous mature sebaceous glands located on the upper dermis below the epidermis (Fig. 2b). The histological report was “Nipple Sebaceous Hyperplasia.” Sebaceous gland hyperplasia is an uncommon benign, well-recognized skin condition commonly located on the face, whose etiology is unknown. The lesions are found usually in men and located on the nose, forehead, and cheeks. Other locations, such as the areola, are considered exceptional. The more frequent clinical presentation of ASH is a yellowish plaque/papula-like or a diffuse areola thickening/swelling with multilobular involvement. In only one case, did the lesion show spadiceous papules and peduncolated nodules with a verruciformis aspect. In eight cases, there was a bilateral presentation (5F and 3M), whereas in the other seven, including ours, the presentation was unilateral (4F and 3M). The age range was 24– 59 years (median 42.5 years). The authors have no financial interest or other associations to disclosure. Centro Barberio, Naples, Italy Senologia Clinica Mediterranea, Naples, Italy Department of Public Health, Cytology Service, Universit a Federico II, Naples, Italy *Correspondence to: Immacolata Cozzolino, Ph.D.; Department of Public Health Universita’ “Federico II,” via Pansini, 5, Napoli 80131, Italy. E-mail: coimma@yahoo.it Received 22 January 2014; revised 31 March 2014; Accepted 9 May 2014 DOI: 10.1002/dc.23181 Published online 00 Month 2014 in Wiley Online Library (wileyonlinelibrary.com).

Sebaceous hyperplasia is a benign lesion that occurs commonly on the face of older individuals. A variety of treatment options have been described, including oral isotretinoin, electrodesiccation, CO2 laser surgery, cryosurgery, and shave excision with curettage. Problems have been noted with these approaches. These techniques are more complex, less effective, require more time, or are more likely to scar than the procedure we describe. The treatment of sebaceous hyperplasia with bichloracetic acid is described with results presented after treatment of our first 20 patients.

Fordyce's spot-like lesions were observed in both areolae of a 43-year-old female. The histology of the lesions showed sebaceous hyperplasia.

Sebaceous hyperplasia is a common benign proliferation of the sebaceous gland. It commonly presents in middle-aged people as soft, yellow papules with central umbilication on the face, particularly on the forehead. We report a newborn with striking unilateral sebaceous hyperplasia and suggest that this may represent a unique sebaceous hamartoma rather than “premature sebaceous hyperplasia.”

Epidermal hyperplasia, sometimes with primitive hair follicle-like differentiation, is a characteristic finding overlying dermatofibroma. We here report plate-like sebaceous hyperplasia overlying a dermatofibroma. Such changes are interpreted as a result of inductive epithelial effect by the dermatofibroma on the overlying epidermis.

Sebaceous hyperplasia commonly occurs on the face and occasionally on the neck, mainly in elderly individuals. Areolar involvement is a rare distinctive entity with an increasing number of male cases being reported. This is also the first reported case of unilateral sebaceous hyperplasia occurring in a male, as plaque morphology.

We present a case series of 63 patients diagnosed with juxta-clavicular beaded lines. This condition is more frequent in dark-skinned people and corresponds to an anatomical variant of simple sebaceous hyperplasia. In view of the strong reactivity of the melanocytes in dark-skinned people, and of the possible hypochromic results, no treatment is advised.

Sebaceous hyperplasia is a benign condition that is seen commonly on the face of elderly persons as single or multiple yellowish papules. It also occurs on the lips, oral mucosa, neck and tlid pants. An unusual present tatton of a band-like sebaceous hyperplasia over the penis in a 54-year-old man is described.

Neurofibromatosis is associated with cutaneous melanin pigmentation, but an association with ordinary melanocytic nevi has not been described. This retrospective case-control study was designed to see if neurofibromas in patients with Neurofibromatosis, Type I (NF-1) differ from sporadic neurofibromas (SN) in their incidence of associated melanocytic nevi and other histologic features. Slides from 114 NF-1 were compared with 112 SN. Lentiginous melanocytic nevi were identified over 13 NF-1 (11%) but no SN (p = 0.00019, Fisher’s test). Compared with other NF-1, NF-1 with nevi were more frequently associated with melanocytic hyperplasia, honeycomb infiltration of the subcutis (p

Neoplasms with sebaceous differentiation cover a broad spectrum. They range from benign sebaceous hyperplasia and adenomas to locally infiltrative sebaceous epitheliomas which have biologic behaviors similar to basal cell carcinomas, to sebaceous carcinomas which can have very malignant biologic behaviors. In this paper, we have purposely excluded the nevus sebaceus of .Jadassohn, a nevoid tumor composed of several cutaneous elements. As sebaceous glands are only one part of this tumor, it is better classified as an organoid nevus.