Forum for Nordic Dermato-Venereology Nr1,2019 | Page 5

Mini Review and Case Report C 1 Eruptive Sebaceous Hyperplasia: An Uncommon Side Effect of Systemic Corticosteroid Use in a Renal Transplant Patient Tilføj en Tag b Synes S C arsten S auer M ikkelsen 1 , L uit P enninga 2 , G udjon L eifur G unnars - son 3 and T herese B eate A busland 4 Sponsor Specialist in Dermato-Venereology, Privat Practise, Brønderslev, Denmark, Chief of Department, Ilulissat Hospital, Avannaa Region, Ilulissat, Greenland, 3 Specialist in Plastic Surgery, Hospital in Skien, Skien, Norway, and 4 Specialist in Dermato-Venereology, Aalesund Sygehus, Aalesund, Norway. E-mail: c.s.mik- [email protected] 1 2 I ntroduction S ebaceous hyperplasia is a benign disorder of the sebaceous glands caused by an overabundance of sebocytes. This high number of sebocytes creates an enlargement of the sebaceous gland which can proliferate to several times its regular size. The sebacceous glands produce an oily substance sebum, which presents as flesh coloured or yellowish, shiny bumps (1). Sebaceous hyperplasia primarily occurs in the face, though sebaceous glands are localised everywhere on the body, ex- cept for the palms of the hands and soles of the feet (1, 2). Newly formed papules often swell with sweating which is pathognomic for the disorder. Sebaceous glands are commonly associated with hair follicles, but are also present in hairless regions of the skin (1). Zalando zalando.n Uanset o har vi nog the calcineuri inhibitor tacrolimus has been reported with sebaceous hyperplasia (6). Furthermore, there has only been one report on the occurrence of eruptive sebaceous hyperplasia associated with immunosuppression with prednisolone (7). In the present case we also report on the occurrence of sebaceous hyperplasia associated with corticosteroid use. Eruptive sebaceous hyperplasia is a benign disorder, and no malignant proliferation has been reported. Patients often ask for treatment due to cosmetic reasons, particularly because the disorder primarily affects the face. Isotretoin has been found to be effective in the treatment of eruptive sebaceous hyperplasia (4, 6). Treatment with CO 2 laser has also been found to be successful (6). As mentioned above eruptive sebaceous hyperplasia is a benign disorder. Special care should though be taken when The symptoms of sebaceous hyperplasia are 1–5 mm large skin diseases occur in organ transplant recipients receiving papules on the skin, mainly on the forehead, nose and cheeks, immunosuppressive agents, as transplant recipients are at high and seborrhoeic facial skin. The papules may have cauliflower risk of developing other skin diseases, including skin cancers. shape. Eruptive sebaceous hyperplasia occurs primarily in men Simultaneous occurrence of eruptive (2). The disorder is seldom in young Eruptive sebaceous hyperplasia is a benign hyperplasia and basal cell carcinoma in people, but is typically seen in mid- a transplant has also been reported. So disorder, and no malignant proliferation dle-aged and elderly people due to the when in doubt, diagnosis of skin diseas- has been reported. Patients often ask for ageing proces in the sebaceous gland (3). treatment due to cosmetic reasons, particu- es in organ transplant patients should larly because the disorder primarily affects be confirmed histologically. Eruptive sebaceous hyperplasia can the face. occur as an inherited disorder, which is called familial eruptive sebaceous C ase presentation hyperplasia (4). Sebaceous hyperplasia A 49-year-old Caucasian man received a renal transplant 25 has also been reported in patients who are treated with im- years ago followed by long-term systemic treatment with munsuppressive agents following solid organ transplantation. prednisolone, and short-term treatment with cyclosporin and Secondary eruptive familial hyperplasia has predominantly azathioprine. He recently presented with the sudden appear- been associated with treatment with the calcineurin inhibitor ance of multiple asymptomatic growths. Skin examination cyclosporin following organ transplantation (2, 5). It has been revealed multiple 1–5 mm, soft, skin-coloured to yellowish, suggested that cyclosporin might stimulate sebaceous gland dome-shaped, umbilicated papules primary on the forehead proliferation (5). One study reported the occurrence of seba- but also bilaterally on the lateral/malar cheeks, clinically sug- ceous hyperplasia in 16% of heart transplant patients treated gestive and confirmed histologically as sebaceous hyperplasia with cyclosporin (2). In contrast, only one patient treated with ” Forum for Nord Derm Ven 2019, Vol. 24, No. 1 3