(Adenoma of the sebaceous glands)
If we exclude sebaceous cysts or wens from the adenomata, adenoma sebaceum becomes a rare disease. It is characterized by pin-head- to split-pea-sized, round or convex growths which are the color of normal skin, waxy, brownish or reddish. These multiple lesions may show smooth, rough, warty or varicose surfaces, the latter aspect being influenced by the degree of telangiectasis present. They are apt to involve the same regions as rosacea and are often cutaneous lesions may be found such as nevi, warts, comedones, fibromata and pigmentation, as well as a coarse large-pored skin.
Etiology and Pathology. – Nearly all the cases recorded have been found among the poor and mentally deficient, especially among children in asylums for the weak-minded. It may not be true that all cases are congenital but this influence is undoubtedly very strong. Pathologically there is a hyperplasia of the sebaceous glands and probably of the sweat-glands.
Diagnosis. – The region involved, the associated telangiectasis, persistent course and its appearance in early life are the diagnostic points of adenoma sebaceum. Rosacea starts later, becomes pustular and has a progressive tendency. Multiple benign cystic epithelioma is differently distributed, occurring on the back, chest and arms. Colloid degeneration usually occupies the frontal and orbital regions, its lesions are rarely numerous and have a yellowish translucent look without dilated capillaries. Molluscum contagiosum has a central depression and opening.
Prognosis and Treatment. – Spontaneous involution has been observed but the malady is usually persistent. Treatment is wholly surgical. Small lesions may be destroyed by electrolysis nd the larger by excision. Multiple scarification has been urged and a case of my own was cured by curetting, followed by carbolic and cauterization. Thuja and Fluoric acid have been used in indicated cases with much benefit.