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Sebaceous Hyperplasia — SCE Dermatology MCQ

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HardSkin CancerSebaceous HyperplasiaSCE Dermatology

A transplant recipient has a solitary enlarging yellow-pink facial papule with a central dell and irregular arborizing vessels rather than a symmetric crown pattern. What is the best next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Biopsy the lesion to exclude basal-cell carcinoma or another adnexal tumour

Explanation lettering: C = shown as A · D = shown as B · A = shown as C · B = shown as D

E is correct. Typical sebaceous hyperplasia is multiple, stable and symmetric, with yellow lobules and crown vessels that approach but do not cross the centre. A solitary enlarging lesion with irregular arborizing vessels in an immunosuppressed patient is not safely assumed benign and requires tissue diagnosis to exclude BCC or another adnexal neoplasm. A central dell is not pathognomonic. Empirical cosmetic treatment or destructive curettage can delay diagnosis and remove architecture. Immunosuppression increases rather than lowers cutaneous malignancy risk.

Reference: Primary Care Dermatology Society: sebaceous gland hyperplasia: https://www.pcds.org.uk/clinical-guidance/sebaceous-gland-hyperplasia