At follow-up 2 weeks later, pathology revealed a diagnosis of sebaceous hyperplasia (SH). On close examination of the face and nose, the FP noted other nonpigmented SHs and telangiectasias, which confirmed an overall diagnosis of rosacea.
The FP explained to the patient that SH is benign and that there are treatments for rosacea. In this case, the FP prescribed 1% metronidazole gel for the rosacea. At follow-up one month later, the shave biopsy had effectively removed the SH and the site had healed well. The metronidazole gel was also improving the appearance of the patient’s face. The patient indicated that he’d been avoiding the sun and drinking less alcohol, which was helping the rosacea and was, of course, good for his overall health.
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Smith M. Sebaceous hyperplasia. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013: 931-934.
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