Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA.
Veterans Affairs Hospital and SUNY Downstate Dermatology Service, Brooklyn, New York, USA.
Dermatol Ther. 2021 Mar;34(2):e14862. doi: 10.1111/dth.14862. Epub 2021 Feb 19.
Sebaceous glands are sebum-secreting components of pilosebaceous units. In the second of this two-part series, we review the pathologies in which sebaceous glands are primarily and secondarily implicated. They are primarily involved in steatocystoma simplex and multiplex, sebaceous gland hyperplasia, sebaceoma, sebaceous adenoma, sebaceous carcinoma, nevus sebaceus, and folliculosebaceous cystic hamartoma. Sebaceous glands are secondarily involved in acne vulgaris, seborrheic dermatitis, and androgenic alopecia. Steatocystoma multiplex is a benign congenital anomaly presenting as yellow cysts primarily on the upper body. Sebaceous gland hyperplasia is characterized by yellow, telangiectatic papules with a central dell, and it can be treated with topical retinoids or surgical excision. Sebaceoma clinically presents on the head and neck region as a skin-colored nodule and can be distinguished by immunohistochemistry. Stains used in the diagnosis of sebaceous adenoma and carcinoma include epithelial membrane antigen and adipophilin immunoperoxidase. Surgical excision is the preferred treatment for sebaceoma, sebaceous adenoma, and sebaceous carcinoma. Excision is not always indicated for nevus sebaceus. Folliculosebaceous cystic hamartoma is a relatively rare condition exhibiting both epithelial and mesenchymal components. Patients with acne vulgaris commonly present with papules of closed and open comedones displaying hypercornification. Seborrheic dermatitis presents as sharply demarcated yellow or red patches or plaques; antifungal agents, corticosteroids, and combination antifungal/anti-inflammatory therapies are common treatment modalities. As a result of hair follicle miniaturization, females with androgenic alopecia present with diffuse hair thinning, while men tend to present with balding and hairline recession.
皮脂腺是毳毛皮脂腺单位的皮脂分泌成分。在这两部分系列中的第二部分中,我们回顾了皮脂腺主要和次要受累的病理学。它们主要涉及单纯性脂囊瘤和多发性脂囊瘤、皮脂腺增生、皮脂腺瘤、皮脂腺腺瘤、皮脂腺癌、皮脂痣和毛囊皮脂腺囊性错构瘤。皮脂腺次要涉及寻常痤疮、脂溢性皮炎和雄激素性脱发。多发性脂囊瘤是一种良性先天性异常,表现为主要在上半身的黄色囊肿。皮脂腺增生的特征是黄色、毛细血管扩张性丘疹,中央凹陷,可通过局部维甲酸或手术切除治疗。皮脂瘤临床上表现为头颈部皮肤色结节,可通过免疫组织化学鉴别。用于诊断皮脂腺腺瘤和癌的染色包括上皮膜抗原和脂肪细胞素免疫过氧化物酶。皮脂瘤、皮脂腺腺瘤和皮脂腺癌的首选治疗方法是手术切除。并非所有皮脂痣都需要切除。毛囊皮脂腺囊性错构瘤是一种相对罕见的疾病,同时具有上皮和间叶成分。寻常痤疮患者常出现闭合性和开放性粉刺的丘疹,表现为过度角化。脂溢性皮炎表现为界限分明的黄色或红色斑块或斑块;抗真菌药物、皮质类固醇和联合抗真菌/抗炎治疗是常见的治疗方法。由于毛囊微小化,女性雄激素性脱发表现为弥漫性头发稀疏,而男性则倾向于出现秃顶和发际线后退。