Detection of Sebaceous Gland Hyperplasia with Dermoscopy and Reflectance Confocal Microscopy

Sebaceous gland hyperplasia (SGH) is a benign cutaneous proliferation of the sebaceous glands that occurs in approximately 1% of the healthy population, mainly males. Our aim was to describe dermoscopy and reflectance confocal microscopy features of sebaceous gland hyperplasia. Thirty-one patients with sebaceous gland hyperplasia diagnosed according to the clinical and histopathological standards were examined using dermoscopy and reflectance confocal microscopy (RCM) from March 2018 to January 2022. Dermoscopically, lesions revealed yellowish-red background and faintyellow background in 25 cases (80.65%) and 6 cases (19.35%) respectively. White-yellowish lobulated structures in the center of the lesion were presented in 31 cases (100%) and umbilications in 19 patients (61.29%). Crown vessels in the peripheral of the lesions were observed in 11 cases (35.48%) while irregular linear vessels on the surface of the lesions in 18 cases (58.06%). Under the reflectance confocal microscopy, all lesions presented a honeycombed pattern in the epidermis and typical morulae-shaped sebaceous lobules in dermis. Dilated follicular infundibulum was observed in 15cases (48.39%) and dilated vessels in 26 cases (83.87%). In conclusion, dermoscopy and RCM enable us to describe the imaging features of SGH. Combing the two useful tools together provides a non-invasive basis for the accuracy of clinical diagnosis.