The correlation of sebaceous hyperplasia and colonic polyposis: An observational study
Sebaceous hyperplasia is a common benign condition involving the sebaceous glands. They are characterised as soft flesh coloured to yellow discrete lesions ranging from a smooth macule to a slightly raised papule. They have a central follicular opening with uniform telangiectasia coursing from the lesion periphery to the centre. They are usually 2-4 mm in diameter with a yellow lobulated appearance dermatoscopically. The pathogenesis of sebaceous hyperplasia is benign with no reports of association with underlying disease1.
Sebaceous adenoma, a far less common benign sebaceous tumour with a well-documented association with Muir-Torre syndrome, is associated with the development of colonic adenomas and adenocarcinoma of the colon1.
In Australia as of 2016, colorectal cancer is the second most common malignancy accounting for about nine percent of all deaths2. Most cases of colorectal cancer are indolent in their course with no early external manifestations of disease2. This delays early detection and compounds the morbidity and mortality associated with colorectal cancer.
In our observational study, of the 131 participants with sebaceous hyperplasia, 62% had colonic polyps. We propose the presence of sebaceous hyperplasia should be added to alcohol and smoking2, as a recognised risk factors for intestinal polyposis. We also propose in patients with sebaceous hyperplasia, colorectal cancer surveillance via at least faecal occult blood and colonoscopy in the higher risk group should be undertaken. This may lead to early intervention of intestinal polyps with tumorigenic potential, resulting in a lower incidence of bowel cancer and overall morbidity and mortality.
1. 1. Ann J, Schwartz R. Muir-Torre syndrome (MTS): An update and approach to diagnosis and management. J Am Acad Dermatol. 2016;74(3):558-66.
2. 2. Bowel cancer (colorectal cancer) in Australia. (2016, November 25). Retrieved from https://bowel-cancer.canceraustralia.gov.au/statistics
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Dr. Jesse Johnston
Clinicopathological Pathological Correlation
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