What is adenoma sebaceum (sebaceous adenoma)?

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Dainyal Siddiqui, MD

Internal Medicine

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Manuel Jimenez, MD

Cardiology

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Franz Pierre-Louis, MD

Infectious Disease

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Last updated: April 27, 2025 • View editorial policy

From the Guidelines

Adenoma sebaceous is a significant risk factor for Lynch syndrome, particularly when combined with a personal or family history of colorectal, endometrial, biliary, small bowel, or ovarian carcinoma. When evaluating a patient with adenoma sebaceous, it is essential to consider the possibility of Lynch syndrome, as outlined in the study by 1. This condition is characterized by an increased risk of various types of cancer, including colorectal, endometrial, and ovarian cancer. Key points to consider in the evaluation of adenoma sebaceous include:

  • Patient selection: Consider screening for Lynch syndrome in patients with adenoma sebaceous, particularly those with a personal or family history of cancer.
  • Risk factors: Patients with adenoma sebaceous and a history of colorectal, endometrial, biliary, small bowel, or ovarian carcinoma, or those who present with upper urinary tract urothelial carcinoma (UTUC) under the age of 60, should be considered for screening.
  • Diagnostic approach: If tissue is available, prioritize testing for immunohistochemistry (IHC) first, followed by polymerase chain reaction (PCR) testing, as recommended by 1.
  • Referral for genetic counseling: Patients with a high clinical suspicion of Lynch syndrome, including those with adenoma sebaceous and a personal or family history of cancer, should be referred for genetic counseling, even if initial test results are negative. It is crucial to recognize the association between adenoma sebaceous and Lynch syndrome to provide appropriate screening and management for patients at risk, as highlighted in the study by 1.

From the Research

Adenoma Sebaceous Treatment Options

  • The copper vapor laser has been shown to be safe and effective for the treatment of adenoma sebaceum in tuberous sclerosis, with good to excellent cosmetic results seen in all treated patients 2.
  • The carbon dioxide laser has been compared to the argon laser for the treatment of angiofibromas in tuberous sclerosis, with the carbon dioxide laser producing superior cosmetic results 3.
  • Topical rapamycin has been reported to yield promising results for the treatment of facial angiofibromas, with additional laser ablation needed for large papules 4.
  • Various treatment options have been used to remove or improve the appearance of facial angiofibromas, including lasers, but there is a lack of treatment guidelines 5.

Treatment Considerations

  • The choice of treatment for adenoma sebaceum may depend on the size and location of the lesions, as well as the patient's skin type and other factors 3, 4.
  • Combination therapy, such as topical rapamycin and laser ablation, may be needed to achieve optimal results 4.
  • The natural course of facial angiofibromas should be considered when selecting a treatment option, with topical rapamycin potentially being more effective in childhood patients 4.

References

2
Research

Treatment of adenoma sebaceum with the copper vapor laser.

Journal of the American Academy of Dermatology, 1995

5
Research

Current options for the treatment of facial angiofibromas.

Actas dermo-sifiliograficas, 2014

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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