The classic yellow donut on the face.
Sebaceous hyperplasia (SH) is a focal overgrowth of sebaceous glands typically presenting as a "tiny, yellow donut" on the face of an adult. One study did not show it to be related to sun exposure. Idiopathic, senile SH is by far the most common variant occurring on the face of older adults. Forms of SH include:
A yellow "donut-shaped" papule is seen on the face. Multiple lesions are common in older patients. Larger lesions may appear as yellowish plaques with an irregular surface. Rare, diffuse multiple sebaceous hyperplasia has been reported. It may be seen in some cases secondary to cyclosporin, post Stevens-Johnson syndrome [JAAD 2011;65, Issue 2, Pages 446–448] and familial.
No treatment is needed. If treatment is desired for cosmeses, a test area should be performed first. Sometimes the goal is just to make the lesions flat as aggressive destruction can make a hole. Light electrodessication can be done. The 1720 nm laser is selectively absorbed by fat and has been reported effective for sebaceous hyperplasia. Low dose isotretinoin off label works well temporarily e.g. 10-20 mg/day, but the lesions reform once the isotretinoin is stopped.
SH may be easily treated with the topical application of 100% dichloracetic acid [The Journal of dermatologic surgery and oncology 17.11 (1991): 876].
Liquid nitrogen usually is not effective. PDT does not seem to work.
Multiple eruptive SH after Stevens Johnson Syndrome. From JAAD 2011;65, Issue 2, Pages 446–448.
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