Light and laser therapies for the treatment of sebaceous gland hyperplasia a review of the literature

Sebaceous hyperplasia of the eyelid: A comprehensive case report and literature review

Introduction

Sebaceous gland hyperplasia of the eyelids, known as adenomatoid or pseudoadenomatous hyperplasia, is a rare benign condition. Optimal management strategies for this specific type of eyelid tumor require further investigation.

Case presentation

The patient presented with a 21-year history of a progressively enlarged mass in the right lower eyelid. Previous treatments, including laser photocoagulation and surgical excision, have failed to prevent recurrence. The mass, characterized by a firm texture and low mobility, has raised concerns regarding malignancy. However, histopathological examination following surgical excision identified the mass as sebaceous gland hyperplasia. The patient's medical history was notable for benign gastrointestinal and intestinal polyps with no evidence of malignancy.

Conclusions

A final diagnosis of eyelid sebaceous gland hyperplasia was established after surgical excision and comprehensive histopathological analyses. The patient's successful recovery without recurrence over a three-month follow-up period post-surgery highlights the efficacy of the surgical approach and the use of intraoperative frozen section pathological examination.

Sebaceous Neoplasms

Sebaceous neoplasms describe a group of tumors with sebaceous differentiation commonly seen in lesions located primarily in the face and neck. The majority of these lesions are benign, while malignant neoplasms with sebaceous differentiation are uncommon. Sebaceous tumors present a strong association with the Muir-Torre Syndrome. Patients suspected with this syndrome should undergo neoplasm excision, followed by histopathologic and additional immunohistochemistry and genetics examinations. Clinical and dermoscopic features of the sebaceous neoplasms, as well as management procedures collected from the literature analysis regarding sebaceous carcinoma, sebaceoma/sebaceous adenoma, and sebaceous hyperplasia are described in the current review. A special note is made for describing the Muir-Torre Syndrome in patients presenting multiple sebaceous tumors.

1.7 µm - 1.73 µm tunable ultrafast Raman fiber laser pumped by 1.6 µm dissipative soliton pulses

Here, we report an all-fiber tunable ultrafast Raman laser synchronously pumped by a home-made 1.6 µm dissipative soliton (DS) picosecond (ps) laser, which produces Stokes light beyond 1.7 µm. The Raman gain medium is a segment of highly germanium-doped (Ge-doped) fiber offering a high Raman gain coefficient at the target wavelength. Once the Raman conversion cavity is synchronized with the pump light, a stable 1.7 µm Raman laser (the first Stokes light) can be obtained at a low pump threshold. The maximum output power of the 1.7 µm Raman laser can reach ∼ 22.62 mW. The wavelength tuning operation is independent of tunable pump source and intra-cavity filter. By adjusting the intra-cavity delay line simply, the different spectral component within the broad Raman gain bandwidth can be selectively synchronized with the pump light so that the Raman laser wavelength can be tuned continuously from 1702.6 nm ∼ 1728.84 nm. This tunable 1.7 µm waveband ultrafast laser will have potential applications in multiphoton microscopy for e.g. deep bio-imaging.

Aging in the sebaceous gland

Sebaceous glands (SGs) originate from hair follicular stem cells and secrete lipids to lubricate the skin. The coordinated effects of intrinsic and extrinsic aging factors generate degradation of SGs at a late age. Senescence of SGs could be a mirror of the late aging of both the human body and skin. The procedure of SG aging goes over an initial SG hyperplasia at light-exposed skin areas to end with SG atrophy, decreased sebum secretion, and altered sebum composition, which is related to skin dryness, lack of brightness, xerosis, roughness, desquamation, and pruritus. During differentiation and aging of SGs, many signaling pathways, such as Wnt/β-catenin, c-Myc, aryl hydrocarbon receptor (AhR), and p53 pathways, are involved. Random processes lead to random cell and DNA damage due to the production of free radicals during the lifespan and neuroendocrine system alterations. Extrinsic factors include sunlight exposure (photoaging), environmental pollution, and cigarette smoking, which can directly activate signaling pathways, such as Wnt/β-catenin, Notch, AhR, and p53 pathways, and are probably associated with the de-differentiation and hyperplasia of SGs, or indirectly activate the abovementioned signaling pathways by elevating the inflammation level. The production of ROS during intrinsic SG aging is less, the signaling pathways are activated slowly and mildly, and sebocytes are still differentiated, yet terminal differentiation is not completed. With extrinsic factors, relevant signaling pathways are activated rapidly and fiercely, thus inhibiting the differentiation of progenitor sebocytes and even inducing the differentiation of progenitor sebocytes into keratinocytes. The management of SG aging is also mentioned.

Safety and Efficacy of Nanosecond Pulsed Electric Field Treatment of Sebaceous Gland Hyperplasia

BACKGROUND

Nanosecond pulsed electric field (nsPEF) technology involves delivery of ultrashort pulses of electrical energy and is a nonthermal, drug-free technology that has demonstrated favorable effects on cellular structures of the dermis and epidermis.

OBJECTIVE

Determine the tolerability and effectiveness of nsPEF treatment of sebaceous gland hyperplasia (SGH).

METHODS

This study was a prospective, randomized, open-label, multisite, nonsignificant risk trial in which each subject served as their own control. After injection of local anesthetic, high-intensity, ultrashort pulses of electrical energy were used to treat 72 subjects resulting in a total of 222 treated lesions. Subjects returned for 3 to 4 follow-up evaluations with photographs.

RESULTS

At the final study visit, 99.6% of treated SGH lesions were rated clear or mostly clear and 79.3% of the subjects were satisfied or mostly satisfied with the outcome. At 60 days after nsPEF treatment, 55% of the lesions were judged to have no hyperpigmentation and 31% exhibited mild post-treatment hyperpigmentation. At the last observation for all lesions, 32% of the 222 lesions were noted as having slight volume loss.

CONCLUSION

Nanosecond pulsed electric field procedure is well tolerated and is very effective in the removal of SGHs.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03612570.

Treatment of sebaceous gland hyperplasia: a review of the literature

BACKGROUND

Sebaceous gland hyperplasia (SGH) is a benign cutaneous proliferation of the sebaceous glands that primarily affects the elderly group and frequently appears in individuals receiving long-term ciclosporin therapy such as organ transplant recipients. In the latter group, SGHs are usually multiple in number and occur predominantly on the face. Patients may find their appearance cosmetically undesirable and, in some cases, may result in significant negative psychological impact. There is, therefore, a demand for safe and effective treatment for SGH particularly in this patient group. A variety of treatment modalities have been previously described including electrodessication,surgery, cryotherapy, oral isotretinoin, lasers, and topical photodynamic therapy (PDT).

METHODS

The objective of this paper is to review the various treatment modalities for SGH. We performed a systematic literature review using the National Library of Medicine's PubMed Database, whereby we included articles that met the following criteria: published in English, not focused on SGH in rhinophyma, studies with adult sample with SGH lesions, and studies with patients with SGH related to ciclosporin.

RESULTS

Our findings show that the literature is categorized according to the treatment modalities ranging from conventional techniques such as oral isotretinoin and cryotherapy to more advanced topical PDT, lasers and a combination of both. We found that effectiveness does not depend on the technique itself but instead on the number of lesions, financial cost, psychological factors, skin phototype and age.

CONCLUSIONS

Our work shows that SGH can be treated effectively by customizing the treatment modality according to different parameters, while effectively maintaining clearance of SGH lesions with best cosmetic outcome.

70% Trichloroacetic Acid in the Treatment of Facial Sebaceous Hyperplasia

The present paper highlights the usefulness of 70% trichloroacetic acid in treating sebaceous hyperplasia in elderly patients. Esthetics are an important issue, and different therapeutic modalities can be used, such as systemic isotretinoin, surgical excision, electrocautery, cryosurgery, topical photodynamic therapy and laser, but all these methods are expansive and invasive procedures that may result in scars, which are more extensive than the original lesions.

Evaluation of the Efficacy of Cryosurgery in Patients With Sebaceous Hyperplasia of the Face

Background:

Cryosurgery is an effective treatment for sebaceous hyperplasia, but there have been few clinical studies.

Objectives:

The aim of this study was to evaluate the efficacy and safety of cryosurgery in the treatment of sebaceous hyperplasia.

Methods:

Cryosurgery was performed 6 times, at 2-week intervals, with liquid nitrogen, and evaluated in 40 patients with 517 lesions ranging from 2 to 9 mm over the forehead, cheeks, and chin. All of the lesions were measured before and after the treatment.

Results:

The mean age of the participants was 54.7 ± 8.9 years, and the male/female ratio was 21/19 (1.1). The mean time of the disease duration was 4.2 ± 3.0 years. After 6 cooling cycles, an excellent response (76%-100%) was seen in 341 patients (65.9%), a very good response (51%-75%) was seen in 102 (19.7%), a good response (26%-50%) was seen in 57 (11.1%), a poor response (1%-25%) was seen in 15 (2.9%), and no response (0%) was seen in 2 (0.4%). Age ( P = .004) and sex ( P < .0001) were independent predictors of an excellent response. The excellent response rates were 71.4% for males, 61.8% for females, 70.4% for ages older than 55 years, and 61.8% for ages younger than 55 years. Temporary hyperpigmentation was found in 5 lesions (0.96%), and recurrence was not seen at the 4-month follow-up.

Conclusions:

The well-aimed and controlled used of cryosurgery is an effective method for treating significant cosmetic disfigurement in patients with sebaceous hyperplasia. It is a low-cost therapy without scarring, hypopigmentation, or recurrence.

Photodynamic Therapy and Skin Appendage Disorders: A Review

Photodynamic therapy (PDT) is a noninvasive treatment that utilizes light treatment along with application of a photosensitizing agent. In dermatology, PDT is commonly used and approved for the treatment of oncological conditions such as actinic keratosis, Bowen disease and superficial basal cell carcinoma. In the last 2 decades however, PDT has also been used for the treatment of several nonneoplastic dermatological diseases. The present review summarizes published data on PDT application in skin appendage disorders. Our literature review shows that: (a) PDT may be a suitable treatment for acne, folliculitis decalvans, hidradenitis suppurativa, nail diseases, and sebaceous hyperplasia; (b) there is a lack of agreement on PDT features (type, concentrations and incubation period of used substances, number and frequency of PDT sessions, optimal parameters of light sources, and patient characteristics [e.g., failure to previous treatments, disease severity, body surface area involved, etc.] which should guide PDT use in these diseases);

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.

Photovoltaic surfaces enable clonal myoblastic cell release using visible light as external stimulation

Many new biomedical approaches to treating disease require the supply of cells delivered to an injured or diseased organ either individually, collectively as aggregates or sheets, or encapsulated with a scaffold. The collection of cells is accomplished by using enzymatic digestion witch suffer from the need to remove the enzymes after digestion. In addition, enzymatic methods are not applicable for all cells, cell aggregates, cell sheets or 3D structures. The objective of this study was to investigate the release of cultured cells from silicon based Photovoltaic (PV) surfaces using a light source as external stimulation. C2C12 myoblasts were cultured on the negative surface of a PV device and upon confluence they were exposed to light. The amount of released cells was quantified as a function light exposure. It was found that light exposure at 25,000 lux for one hour caused equivalent cell release from the PV surface than trypsination. The released cells are viable and can be re-cultured if needed. This mechanism may offer an alternative method to release excitable cells without using an enzymatic agent. This may be important for cell therapy if larger cell structures such as sheets need to be collected.