Hyperplastic Sebaceous Glands Research Articles

The Relationship of Hardiness and Self-attitude in Adolescents with Acne

Acne (acne vulgaris) is a chronic inflammatory skin disease resulting from the overproduction of sebum and blockage hyperplastic sebaceous glands with subsequent inflammation. The disease most commonly occurs in puberty and affects more than half of the adolescent population. The aim of this investigation was to study the specificity of such psychological characteristics such as hardiness and self-attitude of adolescents suffering from acne moderate and severe stages. The research subjects were 107 adolescents with acne (57 males and 50 females) undergoing treatment at the dermatological Department SPbSPMU (St. Petersburg State Pediatric Medical University), the comparison group included 100 apparently healthy adolescents (50 male, 50 female). The study used the Test of hardiness S. Maddi adaptation D.A. Leontiev and E.I. Rasskazova and research technique of self-attitude by S.R. Pantileev and V.V. Stolin. We found that self-doubt, dissatisfaction with oneself as a personality, expectation of negative attitude from others are detected in adolescents with acne and cosmetic defect in this study. Low level of the hardiness is associated with the inability to resist circumstances, to see themselves as the source of activity and with negative emotional position to themselves. On the other hand, adolescents with acne with a high level of indicators of hardiness are characterized by the lack of internal tensions, self-confidence, willingness to be proactive and positive expectations from the surrounding reality, including the relationship to them of other people.

Multiple viral plaques with sebaceous differentiation associated with an unclassified papillomavirus type in a cat

CASE HISTORY AND CLINICAL FINDINGSA 15-year-old neutered male domestic short-haired cat was presented due to multiple 0.5–2 cm-diameter crusting plaques in the left preauricular region, over the bridge of nose, and in the right periocular region. The plaques did not appear to cause discomfort.HISTOPATHOLOGICAL FINDINGSBiopsy samples of four plaques were examined histologically. Three plaques consisted of well-demarcated foci of mild epidermal hyperplasia overlying markedly hyperplastic sebaceous glands. Approximately 60% of the hyperplastic cells contained a large cytoplasmic vacuole that ranged from being clear to containing prominent grey-blue fibrillar material. The fourth plaque was composed solely of epidermal hyperplasia, consistent with previous descriptions of feline viral plaques.MOLECULAR BIOLOGYPapillomavirus DNA was amplified from all four plaques using PCR. A single DNA sequence was amplified from the plaques with sebaceous differentiation. This sequence was identical to the FdPV-MY sequence previously suggested to be from a putative unclassified papillomavirus type. Felis catus papillomavirus type 2 sequences were amplified from the plaque typical of feline viral plaques. Immunohistochemistry to detect p16CDKN2A protein (p16) showed marked immunostaining throughout the hyperplastic epidermis and adnexal structures within the plaques with sebaceous differentiation.DIAGNOSISMultiple feline viral plaques with variable sebaceous differentiation.CLINICAL RELEVANCEFeline viral plaques with sebaceous differentiation have not been previously reported in cats. The presence of unique cell changes within these lesions, the detection of an unclassified papillomavirus type, and the p16 immunostaining within these plaques suggest that they may have been caused by the papillomavirus that contains the FdPV-MY sequence.

Trichoscopy: The Best Auxiliary Tool in the Evaluation of Nevus Sebaceous.

Introduction:Nevus sebaceous (NS) presents as alopecia and yellowish discoloration during infantile stage. In adult stage, lesions become verrucous. Importantly, various appendageal tumors such as trichoblastoma, syringocystadenoma papilliferum and basal cell carcinoma develop during this stage. Hence it is very important to follow the course of NS for early detection of neoplasms. Trichoscopy, being in vivo diagnostic technique, can be utilized in this condition. as it demonstrates specific trichoscopic patterns. Patterns of NS on trichoscopy are evaluated.Materials and Methods:Study was conducted in SN Medical College, Bagalkot. It is a case series study. Ten patients with NS were studied using polarised dermoscopy. All NS lesions were subjected to histopathology for confirmation of diagnosis. Correlation of histopathological changes and trichoscopic patterns was done. Data were tabulated in Microsoft excel sheet. The results are presented in proportions and percentages.Results:Total of 10 patients including 6males and 4 females were present in the study. The mean age was 20years. Two patients were with childhood stage and 8 patients were with adulthood stage of NS. Trichoscopy showed ‘cobble stone pattern’ in 20% and ‘cerebriform pattern’ in 80% of patients. Histopathological features showed numerous and hyperplastic sebaceous glands with primordial hair follicles which were consistent with NS in all the patients.Conclusion:Trichoscopy helps in the diagnosis of NS with specific patterns. Yellowish globules in the cobblestone pattern and cerebriform patterns are specific to childhood and adult stages of NS respectively. Hence, trichoscopy is good, non-invasive diagnostic technique in NS. Authors strongly recommend regular trichoscopic examination of NS.

A Case of Cyclosporine-Induced Sebaceous Hyperplasia in a Renal Transplant Patient Successfully Treated with Isotretinoin.

Dear Editor: Sebaceous hyperplasia (SH) is a benign proliferation of the sebaceous glands that develops as a result of intrinsic aging, photo-aging, exposure to ultraviolet radiation, and genetic predisposition. Organ transplant recipients are susceptible to SH particularly on the face, where multiple large lesions may cause cosmetic concern. Several studies in the literature report SH being induced by cyclosporine due to immunosuppression of patients undergoing organ transplant. Oral isotretinoin and topical photodynamic therapy has previously been reported as a treatment for SH in immunocompetent individuals1,2,3. Other options include electrodesiccation, shave excision and carbon dioxide laser. However, only three cases of cyclosporine-induced SH in a kidney transplant population treated with oral isotretinoin have been reported in the English literature2,3. Therefore, we report a case of cyclosporine-induced SH in a renal transplant recipient successfully treated with oral isotretinoin, along with a review of the literature. A 40-year old Korean man presented in 2013 with multiple skin-colored papules on his face. He had undergone renal transplantation surgery in 1996, following which, he was immunosuppressed with oral cyclosporine and prednisolone for 11 years. He started to notice the facial lesions during this period. The initial doses were cyclosporine 350 mg (5.0 mg/kg body weight) and prednisolone 7.5 mg. The initial dosage was tapered and the patient eventually stopped taking the immunosuppressants in 2007. The patient then started taking tacrolimus 6 mg and prednisolone 5 mg for 4 years. Examination of his face revealed approximately a hundred skin-colored, umbilicated papules, 2 to 4 mm in size, which had increased in number for several years (Fig. 1A). Histological examination of the lesion demonstrated a peculiar superficial localization of the enlarged sebaceous glands in the upper dermis. The patient was diagnosed with SH. He was treated with daily oral isotretinoin 20 mg (0.29 mg/kg) for two months which resulted in near-complete remission without any side effect (Fig. 1B). Two months after discontinuing oral isotretinoin, a few new lesions started to develop. Oral isotretinoin 20 mg was restarted for two months. The lesions cleared without recurrence for nine months. Fig. 1 (A) Prominent multiple hyperplastic sebaceous glands seen as skin-colored papules (arrows) scattered on the right side of the face after treatment of cyclosporine for 11 years and tacrolimus for 4 years. (B) Sebaceous hyperplasia almost completely cleared ... Cyclosporine-induced SH has been reported in several series of organ transplant recipients. Among renal transplant recipients, 7 out of 67 (10%) and 5 out of 82 patients (6%) developed SH. In all cases, the patients were taking cyclosporine4. In an earlier report of 151 kidney transplant recipients who were not taking cyclosporine, SH did not occur5. These studies suggest that cyclosporine is a direct and causative factor of SH. Both tacrolimus and cyclosporine are calcineurin inhibitors sharing similar physicochemical properties and a common mechanism of action - inhibition of proinflammatory cytokines. In addition, both drugs are highly soluble in lipids allowing for cutaneous accumulation of the drugs and leading to dysplastic epithelial proliferation. Therefore, in this patient, it is possible to that oral tacrolimus might have played a role in developing SH. Sebaceous glands are mostly considered by dermatologists in association with acne and seborrhea; thus, the antiproliferative and sebostatic effects of isotretinoin have been extensively studied. Isotretinoin causes cell cycle arrest in human staphylococcal enterotoxin B-1 sebocytes in vitro, and apoptosis in human sebaceous glands in vivo2. To our knowledge, there are two other reports of renal transplant recipients receiving treatment for SH with isotretinoin (Table 1)2,3. Other reported effective treatments for cyclosporine-induced SH in patients undergoing renal transplant include carbon dioxide laser and topical photodynamic therapy. Table 1 Summary of previously reported cases of kidney transplant recipient receiving treatment for sebaceous hyperplasia with isotretinoin In conclusion, our case provides additional support for the safe and effective use of oral isotretinoin for cyclosporine-induced SH in patients undergoing renal transplant. However, further studies are needed to establish a treatment protocol for cyclosporine-induced SH in patients undergoing renal transplant.

Repeated salicylic acid peels for the treatment of hyperplastic sebaceous glands in hypohidrotic ectodermal dysplasia

Hypohidrotic ectodermal dysplasia (Christ-Siemens-Touraine syndrome) is the most common type of ectodermal dysplasia. Hypertrophic sebaceous glands (HSGs) are rarely present but they cause an aesthetic problem. We report a case of a patient suffering from hypohidrotic ectodermal dysplasia, treated with salicylic acid peels for the hyperplastic sebaceous glands.

PPARγ-Mediated and Arachidonic Acid–Dependent Signaling Is Involved in Differentiation and Lipid Production of Human Sebocytes

The transcriptional basis of sebocyte differentiation and lipid production is mostly unclear. Peroxisome proliferator-activated receptor gamma (PPARγ), a lipid-activated transcription factor, has been implicated in differentiation and lipid metabolism of various cell types. Here, we show that PPARγ is differentially expressed in normal and pathological human sebocytes and appears to have roles in their differentiation and lipid production. We used laser-microdissected normal and pathological human sebaceous glands (SGs) and SZ95 cells (immortalized sebocyte cell line) analyzed by real-time quantitative PCR and immunohistochemistry. Lipids were analyzed by quantitative fluorimetry- and mass spectrometry-based approaches. We have observed that PPARγ and its target genes, ADRP (adipose differentiation-related protein) and PGAR (PPARγ angiopoietin-related protein), are expressed in sebocytes and show association with their level of differentiation. Also, PPARγ is present in normal and hyperplastic SG, whereas its expression levels are decreased in SG adenoma and SG carcinoma cells, reflecting a maturation-linked expression pattern. Furthermore, in SZ95 sebocytes, naturally occurring lipids, including arachidonic acid and arachidonic acid keto-metabolites (e.g., 5-KETE (5-oxo-6E,8Z,11Z,14Z-eicosatetraenoic acid), 12-KETE (12-oxo-5Z,8Z,10E,14Z-eicosatetraenoic acid)), appear to regulate PPARγ signaling pathways, which in turn modulate phospholipid biosynthesis and induce neutral lipid synthesis. Collectively, our findings highlight the importance of endogenous ligand-activated PPARγ signaling in human sebocyte biology and suggest that PPARγ might be a promising candidate for the clinical management of SG disorders.

Progressive Alopecia Reveals Decreasing Stem Cell Activation Probability during Aging of Mice with Epidermal Deletion of DNA Methyltransferase 1

To examine the roles of epigenetic modulation on hair follicle regeneration, we generated mice with a K14Cre-mediated loss of DNA methyltransferase (DNMT) 1. The mutant shows an uneven epidermal thickness and alterations in hair follicle size. When formed, hair follicle architecture and differentiation appear normal. Hair subtypes exist but hair fibers are shorter and thinner. Hair numbers appear normal at birth but gradually decrease to fewer than 50% of control in 1 year old mice. Sections of old mutant skin shows follicles in prolonged telogen with hyperplastic sebaceous glands. Anagen follicles in mutants exhibit decreased proliferation and increased apoptosis in matrix transient amplifying cells. Although K15 positive stem cells in the mutant bulge are comparable in number to the control, their ability to proliferate and become activated to form a hair germ is reduced. As mice age, residual DNMT activity declines further and the probability of successful anagen reentry decreases, leading to progressive alopecia. Paradoxically, there is increased proliferation in the epidermis which also shows aberrant differentiation. These results highlight the importance of DNA methylation in maintaining stem cell homeostasis during the development and regeneration of ectodermal organs.

The Dermoscopic Differential Diagnosis of Yellow Lobularlike Structures

T HE DERMOSCOPIC FEATURE OF YELLOW LOBUlarlike structures has been described in sebaceous hyperplasia. The dermoscopic appearance of aggregated yellow globules with or without a central puncta and fine, nonarborizing blood vessels (“crown vessels”) is thought to be classic for sebaceous hyperplasia. However, these features are not limited solely to sebaceous hyperplasia (Figure 1). These structures may also be seen in nevus sebaceous of Jadassohn (Figure 2) and sebaceous adenoma (Muir-Torre syndrome) (Figure 3). Histopathologically, yellow lobules correspond to dermal conglomerations of sebaceous glands, a feature shared by these 3 lesions. Dermoscopically, small blood vessels may also be seen at the periphery of the yellow lobularlike structures, representing dermal vessels displaced by lobules of hyperplastic sebaceous glands. Thus, when yellow lobularlike structures are visualized on dermoscopy, the differential diagnosis includes not only sebaceous hyperplasia but also other conditions with sebaceous differentiation such as nevus sebaceous and sebaceous adenoma.

Dermoscopy of Sebaceous Hyperplasia

T HE LESIONS ARE FROM THE FOREHEAD OF A 67-year-old woman (Figure 1), the left cheek of a 57-year-old man (Figure 2), and the right cheek of a 49-year-old man (Figure 3) (size bar, 3 mm). All 3 lesions reveal a similar pattern. Aggregated white or yellow nodules can be identified at the center of the lesion. These yellowish nodules correspond to hyperplastic sebaceous glands. Sometimes the ostium of the gland is visible as a small crater. The yellowish nodules are surrounded by groups of orderly winding, scarcely branching vessels. The vessels may extend toward the center but they never cross it. They are not arborizing. Their pattern can be described clearly by the term “crown vessels” and this vascular pattern is specific for hyperplastic sebaceous glands. Editor’s Note: The skINsight section is a forum for the presentation of dermatologic images. The current effort is to foster the recognition of patterns in dermatologic disease processes that may enhance both diagnostic and research capabilities. The initial focus is on dermoscopic images. Theoretically, these patterns reflect the interaction of specific gene defects with local environmental factors. The exercise here is to group lesions with similar dermoscopic patterns—not pathologic criteria. The ultimate benign or malignant behavior is not the focus of this section.

Acne neonatorum: a study of 22 cases.

Acne is not uncommon in the neonatal period. Acne neonatorum is characterized by a mainly facial eruption of inflammatory and noninflammatory lesions. It is most commonly mild and transient. Hyperactivity of sebaceous glands, stimulated by neonatal androgens, has been implicated as the underlying pathogenetic mechanism. All patients diagnosed with acne neonatorum in "A. Sygros" Hospital, Athens, Greece, during the years 1993-1996, were evaluated clinically and epidemiologically. Histologic examination and smears for Propionibacterium acnes and Pityrosporum ovale were performed in selected cases. Of the 22 patients studied, 18 were male (81.8%) and 4 were female. The mean age at onset was 3 weeks and the mean duration of the disease was 4 months. Papules and pustules were the most frequent types of lesions (72.7%), followed by comedones only (22.7%). The cheeks were the most common site of predilection (81.8%). A family history of acne was reported in only three patients. Histologic examination showed hyperplastic sebaceous glands with keratin-plugged orifices. Smears for P. ovale were negative. Our findings are consistent with previous experience, although inflammatory lesions were encountered more often than previously reported. Hereditary factors did not seem to play a significant role in our series. Topical treatment hastened the resolution of this self-limited condition. Recalcitrant cases warrant investigation for underlying androgen excess.

PTHrP Regulates Epidermal Differentiation in Adult Mice

Emerging evidence suggests that parathyroid hormone-related peptide (PTHrP) serves as a regulator of the development and/or differentiation of a number of organs, including endochondral bone, the tooth, and the mammary gland. Although disruption of the PTHrP gene by homologous recombination results in a lethal chondrodystrophy, PTHrP-knockout mice that have been rescued by the transgenic replacement of the peptide in cartilage display abnormalities in ectodermally derived structures including the skin. At 6-8 wk of age, these rescued PTHrP-knockout mice displayed a markedly thinned epidermis and striking hyperkeratosis, hypoplastic sebaceous glands, and a fibrotic dermis. In contrast, transgenic mice that overexpress PTHrP by virtue of the human keratin-14 promoter displayed a thickened ventral epidermis with marked acanthosis and papillomatosis, hyperplastic sebaceous glands, and a cellular dermis. The absence of PTHrP appeared to result in the reduction of the basal keratinocyte compartment and premature acquisition of suprabasal and granular differentiation markers, whereas overexpression of the peptide generated reciprocal findings. No difference in the epidermal proliferation rate was found in PTHrP-null skin and although an increase was observed in keratin 14-PTHrP transgenic animals, their epidermis did not express the hyperplasia marker K6. Finally, the replacement of PTHrP in the basal keratinocytes of rescued PTHrP-knockout mice under the direction of the keratin 14 promoter reversed the abnormalities seen in PTHrP-null skin. These findings suggest that PTHrP regulates the rate of keratinocyte differentiation in the skin of adult mice.

Effects of topical antiandrogen and 5-alpha-reductase inhibitors on sebaceous glands in male fuzzy rats.

The fuzzy rat, a genetic mutant between hairless and hairy albino rats, expresses androgen-dependent hypersecretion of sebum and hyperplastic sebaceous glands. Using this model for human acne, we examined the effects of inhibitors of human steroid 5 alpha-reductase isozymes, type I (MK 386) and type II (finasteride), and an androgen receptor blocker (RU58841) on regression of glandular and ductal hyperplasia. The above three agents, 1% weight volume, were dissolved into the vehicle (propylene glycol, alcohol and water) and applied on the backs of peripubertal male rats for 2 months. Control and castrate groups received vehicle alone. At 8 weeks, we examined the size the sebaceous glandular lobules and ducts in split epidermal preparations as well as in frozen sections of skin stained with osmium-potassium dichromate solution. The number of bromodeoxyuridine (BrdU)-positive cells was counted in the glandular lobes in split-skin tissues stained with BrdU immunochemistry. The results revealed that the sizes of both lobes and ducts in castrates were 40-60% smaller than in controls. RU58841 induced glandular and ductal regression equivalent to that in castrates. Finasteride induced a moderate degree of lobular and ductal reduction, whereas MK386 caused only ductal regression. Reduction of BrdU-positive cells in the sebaceous lobes was found in the skin treated with finasteride and RU58841. Serum concentrations of testosterone and dihydrotestosterone showed no significant changes in all drug-treated rats. The weight of the prostatic lobes was reduced significantly in rats treated with finasteride but not by the other two agents. RU58841 effectively counteracted endogenous androgens resulting in a suppression of growth of the sebaceous glands but not the prostate. This rodent model for androgen-dependent hyperplasia of the sebaceous glands is useful for the study of many pharmacological aspects comprising the rate of percutaneous absorption, stability and affinity to target organs of the testing compounds, and selection of adequate vehicle for topical application.

Sebaceous Gland Hyperplasia of the Penis

A 22-year-old circumcised white man presented with asymptomatic 1 mm. papular lesions on the penis 11 days in duration. The lesions were arranged around the dorsal surface of the distal penile shaft. Biopsy was performed. Paraffin embedded sections were stained with hematoxylin and eosin. On microscopy benign hyperplastic sebaceous glands were composed of multiple mature lobules that coalesced centrally (see figure). Cases of sebaceous gland hyperplasia from an 8-year period were reviewed for comparison. This review revealed 206 previous patients with sebaceous gland hyperplasia, mostly facial involvement, of whom the majority (198) were elderly (mean age 61.2 years).

Sebaceous Gland Hyperplasia on Rabbit Pinna Induced by Tetradecane

To investigate the pathologic changes of sebaceous glands during comedo formation induced by topically applied substances in a rabbit pinna model, purified tetradecane was inuncted on the ventral aspect of the rabbit pinnas once a day for a week. Histologically, a marked hyperplasia of sebaceous glands, epidermis, and follicular epithelium was seen. These remarkably enlarged sebaceous glands were examined histochemically and ultrastructurally. The acinus size and cell population of the hyperplastic sebaceous gland were significantly increased over those of the normal sebaceous gland. By N-(7-dimethylamino-4-methyl-3-coumarinyl)maleimide staining, normal distribution patterns of sulfhydryl (SH) and disulfide (SS) were seen in the peripheral to differentiating layers in the hyperplastic sebaceous glands. In the terminally differentiated layer, the brilliant SH fluorescence was gradually decreased and the SS fluorescence was gradually increased in intensity, indicating that most SH groups in the sebaceous cells were converted to SS linkages before holocrine secretion. By transmission electron microscopy, several cell layers of undifferentiated sebaceous cells were observed at the periphery of the large sebaceous gland. The differentiating sebaceous cells produced a large number of lipid droplets, which were produced in either rough or smooth endoplasmic reticulum. These cells were abruptly converted into homogeneously electron-dense cells which formed several layers. These homogeneous cells gradually lost their electron density before holocrine secretion. These findings indicate that the sebaceous cells in the hyperplastic sebaceous glands undergo a magnified step-by-step cell differentiation and play a role in slightly modified lipid formation, and that there may be an increased production of sebum in the rabbit pinna model. This is the first report of sebaceous hyperplasia induced by a topically applied substance on skin surface, except for androgens. The hyperplastic sebaceous glands could serve as a model for investigations of sebaceous cell differentiation and lipid formation.