Ciclosporin A-induced sebaceous gland hyperplasia

Epidermoid cysts in kidney transplant patients receiving tacrolimus

We present a series of three kidney transplant patients developing epidermoid cysts after receiving oral tacrolimus for long-term prevention of rejection of the allograft. Cyclosporin A has been known to show this cutaneous adverse drug reaction, but this is the first series of patients with epidermoid cysts following tacrolimus to the best of our knowledge.

Gender- and age-related differences in facial sebaceous glands in Asian skin, as observed by non-invasive analysis using three-dimensional ultrasound microscopy

BACKGROUND

While determining sebaceous gland morphology is useful in the treatment of skin disorders such as acne, a non-invasive assessment method has not been developed. Since age and gender affect sebum level, differences in sebaceous gland morphology according to these factors were investigated.

METHODS

Facial skin was measured using a high-frequency three-dimensional ultrasound microscope. First, the ultrasound images were compared with skin sections. Next, we assessed sebaceous gland morphology. Images of sebaceous gland in the cheeks of young male, young female and elderly female subjects were obtained using ultrasound microscopy, and en face images were processed to measure the sebaceous gland area.

RESULTS

In the ultrasound images, sebaceous glands and also thin collagen fibers, which surrounded the glands, could be detected as low-intensity regions. We called them sebaceous units. In young male subjects, the sebaceous unit areas 900-μm beneath the skin surface were larger than those at 700 μm. In contrast, depth-dependent differences in sebaceous unit area were not observed in young female subjects, indicating that males had cauliflower-shaped sebaceous glands while young females had somewhat more cylindrical and smaller sebaceous glands than the young males. Regarding age, the areas of sebaceous units at 900 μm were diminished and the depth of maximum area was shallower in elderly female subjects compared to young female subjects. Hence, sebaceous glands are considered to shrink with age.

CONCLUSION

Differences in facial sebaceous unit morphology between genders as well as by age groups could be observed using high-frequency ultrasound microscopy.

Cutaneous Complications in Recipients of Lung Transplants: A Pictorial Review

Lung transplant is now an established modality for a broad spectrum of end-stage pulmonary diseases. According to the International Society for Heart and Lung Transplantation Registry, more than 50,000 lung transplants have been performed worldwide, with nearly 11,000 recipients of lung transplants alive in the United States. With the increasing use of lung transplant, pulmonologists must be cognizant of the common as well as the unique posttransplant dermatologic complications. Immunosuppression, infections, and a variety of medications and environmental exposures can contribute to these complications. This review aims to provide representative pictures and describe the pathogenesis, epidemiologic characteristics, and clinical manifestations of dermatologic complications encountered among recipients of lung transplants.

Sebaceous lesions of the skin

Sebaceous differentiation is commonly seen in cutaneous neoplasms, both in the context of lesions showing predominantly sebaceous differentiation (e.g., sebaceous adenoma, sebaceoma and sebaceous carcinoma), or as more focal sebaceous components in neoplasms with other primary lines of differentiation. Sebaceous changes can also be a component of benign cystic lesions or epidermal tumours, and sebaceous hyperplasia is commonly encountered. This review is intended to provide an overview of the cutaneous lesions with sebaceous differentiation, with a particular emphasis on facilitating histological diagnosis of neoplasms. In addition, the role of immunohistochemical studies is outlined, as well as the evaluation of potential cases of Muir-Torre syndrome.

Multiple Eruptive Sebaceous Hyperplasia Secondary to Cyclosporin in a Patient with Bone Marrow Transplantation

Many cutaneous complications have been described in patients treated with cyclosporin. Alterations of the pilosebaceous unit such as hypertrichosis are particularly frequent. However, the occurrence of sebaceous hyperplasia is exceptional. These lesions seem to be specific to cyclosporin rather than secondary to immunosuppression. Here, we report an exceptional case of eruptive and disseminated sebaceous hyperplasia arising in a bone marrow transplant recipient only a few months after starting immunosuppressive treatment with cyclosporin.

Sebaceous Hyperplasia Mimicking Linear Wart over Ear

Sebaceous hyperplasia (SH), a common, benign condition of sebaceous gland, presents most commonly over face. Lesions are usually described as asymptomatic, soft, discrete, and yellow with a surface that ranges from smooth to slightly verrucous. The pathogenesis is not fully understood. It does not require treatment, but many time lesions can be cosmetically unfavorable than, need to be destroyed or excised. A case of 23-year-old male presenting with the skin colored to hyperpigmented linear hyperkeratotic plaque mimicking a wart, over the right ear is presented here, which was diagnosed as SH.

Perioral lesions and dermatoses

The purpose of this article is to review the common neoplasms, infections, and inflammatory dermatoses that may present around or near the mouth. Dental professionals are well positioned to evaluate perioral skin conditions, further contributing to patients' general health. This article includes a review of seborrheic keratosis, warts, actinic keratoses, actinic cheilitis, and squamous cell carcinoma, among several other perioral cutaneous lesions.

Epidemiology of Skin Diseases in Renal Transplant Recipients in a Tertiary Hospital

Introduction: There is no published epidemiological data on skin diseases in kidney transplant recipients in this tropical country, which has multi-ethnic groups with the Chinese as the predominant ethnic group. Materials and Methods: Skin diseases of 143 renal transplant recipients were studied in a skin clinic of a tertiary institution during annual surveillance visits from June 2006 to March 2009. Results: Our study showed that except the common drug specific skin manifestations, sebaceous hyperplasia (56.6%), seborrheic keratosis (60.8%), melanocytic naevi (76.9%), skin tags (37.1%) and viral (29.4%) and fungal (20.3%) infections were the most prevalent skin diseases among renal transplant recipients living in Singapore. The prevalence of pre-malignant and malignant tumours was very low (11.2% actinic keratosis, 1.4% Bowen’s disease, 1.4% squamous cell carcinoma, 0.7% basal cell carcinoma, 0.7% keratoacanthoma). Male predominance was seen in sebaceous hyperplasia (72.4% vs 32.1%), actinic keratosis (17.2% vs 1.8%), viral (36.8% vs 19.6%) and fungal (27.6% vs 8.9%) infections. Our study also showed increased prevalence of sebaceous hyperplasia with increased age but its prevalence was significantly higher than that reported in the age matched general population. The prevalence of seborrheic keratosis, actinic keratosis and viral infection correlated positively with post-transplant duration. Conclusions: Our study provides epidemiological data for the prevalence of skin diseases in renal transplant recipients. It emphasises the importance of dermatologic follow-up for renal transplant patients in order to obtain a diagnosis and manage treatable skin diseases. Keywords: Actinic keratosis, Sebaceous hyperplasia, Seborrheic keratosis

Coexistence of basal cell carcinomas and multiple sebaceous gland hyperplasias in a cyclosporine (ciclosporin)-treated renal transplant recipient

A 55-year-old man presented with multiple, asymptomatic, yellowish papules on his face with a 4-year history, and two non-healing tumoral lesions on his nose with a 7-month history. He was a renal transplant recipient and had been treated with cyclosporine (ciclosporin) for 9 years. A biopsy from the asymptomatic, yellowish papule on the face showed sebaceous gland hyperplasia, and biopsies from the lesions on the nose revealed basal cell carcinomas. The lesions on the nose were excised. Sebaceous gland hyperplasia and skin cancers are among the cutaneous neoplasms observed in renal transplant recipients receiving cyclosporine. To our knowledge, this is the third reported case of the coexistence of basal cell carcinomas and multiple sebaceous gland hyperplasias in a cyclosporine-treated renal transplant recipient.

Sebaceous lesions and their associated syndromes: part I

Sebaceous neoplasms have long been a source of confusion to dermatologists and pathologists alike. Disagreements regarding nomenclature, classification, and management have been longstanding. Sebaceous lesions represent a broad spectrum of interesting entities that range from hamartomas, hyperplasias, and benign tumors to highly malignant neoplasms. This article discusses the clinical and pathologic features of sebaceous hyperplasia, nevus sebaceous of Jadassohn, sebaceous adenoma, seboacanthoma, sebaceous epithelioma, sebaceoma, mantleoma, basal cell carcinoma with sebaceous differentiation, sebomatricoma (sebomatrixoma), and sebaceous carcinoma. Controversies regarding these lesions will be explored, and any relationship with Muir-Torre syndrome will be discussed.

Hyperplasies sébacées profuses du visage induites par la ciclosporine

INTRODUCTION

Many cutaneous complications have been reported in patients treated with cyclosporine. Alterations of the pilosebaceous follicle are particularly frequent. Hypertrichosis, follicular keratosis, acne and folliculitis are very common. Nevertheless, the occurrence of sebaceous hyperplasia is exceptional.

OBSERVATION

A 27 year-old man consulted in February 2003 for a papulous eruption of the face. He was treated by cyclosporine and prednisone since his renal transplantation in 1993. The lesions flowed together on the cheeks, forehead and temples. The histological analysis confirmed the diagnosis of sebaceous hyperplasia. There was a perceptible improvement of the cutaneous state after one month of isotretinoin treatment.

DISCUSSION

Sebaceous hyperplasia appears in about 10 p. 100 of patients treated with cyclosporine. This side effect occurs only in men of a mean age of 40 years. An increase in sebaceous gland size is often described, but profuse forms are uncommon. Our case report is exceptional because of the young age of the patient, and the occurrence of diffuse sebaceous hyperplasia that appeared a long time after the introduction of cyclosporine.