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Are Sebaceous Hyperplasia And Fordyce Spots Associated With Muir-Torre Syndrome?

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Posted on Tue, 4 Apr 2017
Question: Hello.... I have a question regarding sebaceous hyperplasia, which I have been diagnosed with on my face, and fordyce spots, which I have also been diagnosed with on my lips and inside my cheeks.

Unfortunately, I've been suffering from some health anxiety and made the mistake of consulting "Dr. Google" , which led me to some information about rare familial cancer syndromes Lynch syndrome and XXXXXXX Torre. I'm looking for some reassurances....can you please let me know whether fordyce and sebaceous hyperplasia are quite common, as I understand, and (hopefully) that they are not markers for Lynch syndrome and XXXXXXX Torre? I've just had my first screening colonoscopy done, which was clean, my blood work is normal, as are my yearly Pap smears and mammograms. There is no history of colorectal cancer in my family.

Unfortunately, I have a lighted magnifying mirror and see every spot and blemish on my face! I'm in peri menopause, and was also wondering whether hormonal changes can cause an increase in fordyce and sebaceous hyperplasia spots?

Thank you so much for your input!
doctor
Answered by Dr. Dr. Kakkar (2 hours later)
Brief Answer:
Neither sebaceoys hyperplasia nor fordyce spots are markers of cancer syndr

Detailed Answer:
Hello. Thank you for writing to us

I am dr.kakkar (dermatologist).
I have gone through your query and I have noted your concern.
Sebaceous hyperplasia and fordyce spots are not markers of either Muir torre syndrome or lynch syndrome. Among cutaneous tumors sebaceous carcinoma, sebaceous adenomas, sebaceous epithelioma and keratoacanthomas are more strongly linked with these syndromes rather than sebaceous hyperplasia or fordyce spots.
Since perimenopausal and postmenopausal women are relatively estrogen deficient and have more circulating androgens as compared to premenopausal women therefore Fordyce spots may appear more prominent. This would also logically explain lesions of sebaceous hyperplasia due to unapposed androgen action on sebaceous glands.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Kakkar (58 minutes later)
Hello again doctor and thank you for you continued care and reassurances! I'm attaching an image of my forehead currently; you'll see hypopigmented areas where my dermatologist zapped the spots of hyperplasia, and there are a few more popping up; also attached is an image of my forehead before they were removed.

I'm also attaching pictures of my lips and inside cheeks with the Fordyce spots which lately seem more prominent.

As I indicated, although I'm taking cymbalta and xanax as needed for anxiety, my health anxiety is in full swing again I believe due to perimenopause changes (I think I will consult a therapist for CBT). I had posed the question regarding a sebaceous hyperplasia/Muir Torre Lind to an oncologist here on this forum and she replied that it is a marker; of course, that response sent me reeling again, although I realize how rare it is and unlikely (again my colonoscopy was completely clean).

I cannot thank you enough for your continued assurances and help....you have truly been a godsen to me! So, sebaceous hyperplasia and Fordyce spots aren't markers for XXXXXXX Torre and Lynch?!!!!
doctor
Answered by Dr. Dr. Kakkar (18 hours later)
Brief Answer:
You don't have a cancer syndrome

Detailed Answer:
Thank you.

I have viewed the Images.
Yes, you clearly have sebaceous hyperplasia on forehead with post inflammatory hypopigmentation at sites of previous treatment.
Fordyce spots too are quite clear in the Images.
Both of these conditions are very common in dermatology OPD and most doctors don't even screen these patients for these cancer syndromes.
Oral Isotretinoin works for both fordyce spots and Sebaceous hyperplasia. It is a treatment option that can be considered importantly because oral therapy does not have sequelae like hypopigmentation unlike destructive surgical treatment options for sebaceous hyperplasia (e.g electrosurgery, cryotherapy etc). You can talk to your doctor regarding this treatment option.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. Kakkar (3 hours later)
Dr Kakkar, once again, I cannot thank you enough for your reassuring, compassionate, and informative answer and for putting my mind at ease once again. I promise I will not bother you with any further questions!! (and I will no longer consult google for medical conditions!)

I am 100 percent convinced that my latest exacerbation in health anxiety over the last few months (I've always been able to cope with it well) is due to my hormonal changes of being in peri menopause. I've spoken with my doctor about adding buproprion to the cymbalta which I currently take, and we are going to give that a test run; I also take xanax as needed, although I only take it rarely due to its addictive potential.

All of my doctors here reassure me that I am fine and do not have these rare syndromes, that makes me feel better for awhile, then I stupidly resort back to google, once again see some links to rare conditions, and my health anxiety goes into a tailspin once again. I cannot tell you how much being able to reach out to caring doctors like you (albeit on the other side of the world) have helped me immensely. I think I am also going to look into cognitive behavioral therapy, as that is covered by my health insurance.

You are truly a special and delightful doctor -- if you were here in the United State, I would love to be your patient (although you would probably shudder at the idea of having me as a patient with my neurotic questions!).

Thank you once again for your kindness and concern -- have a wonderful day! :)
doctor
Answered by Dr. Dr. Kakkar (10 hours later)
Brief Answer:
you are welcome

Detailed Answer:
Hi. Thank you.

I am happy to have comunicated with you. Its ok to be doubly sure and clear all doubts. No issues with that. I am happy that you took my advice and I was able to help you in some way.

Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Remy Koshy
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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Are Sebaceous Hyperplasia And Fordyce Spots Associated With Muir-Torre Syndrome?

Brief Answer: Neither sebaceoys hyperplasia nor fordyce spots are markers of cancer syndr Detailed Answer: Hello. Thank you for writing to us I am dr.kakkar (dermatologist). I have gone through your query and I have noted your concern. Sebaceous hyperplasia and fordyce spots are not markers of either Muir torre syndrome or lynch syndrome. Among cutaneous tumors sebaceous carcinoma, sebaceous adenomas, sebaceous epithelioma and keratoacanthomas are more strongly linked with these syndromes rather than sebaceous hyperplasia or fordyce spots. Since perimenopausal and postmenopausal women are relatively estrogen deficient and have more circulating androgens as compared to premenopausal women therefore Fordyce spots may appear more prominent. This would also logically explain lesions of sebaceous hyperplasia due to unapposed androgen action on sebaceous glands. Regards