Would you biopsy this asymptomatic papule?

Dermclinic
A Photo Quiz to Hone Dermatologic Skills

Case 2:
A 53-year-old woman is concerned about this asymptomatic, slow-growing lesion on her left cheek, which she first noticed a few months ago. She denies bleeding or pain.

What do you suspect?

A. Basal cell carcinoma.
B. Squamous cell carcinoma.
C. Keratoacanthoma.
D. Seborrheic keratosis.
E. Sebaceous hyperplasia.

(Answer on next page.)

Dermclinic—Answer

Case 2: Sebaceous hyperplasia

This yellowing papule with a central punctum is characteristic of sebaceous hyperplasia, E, a benign overgrowth of a normal sebaceous gland. The lesion is solely of cosmetic concern; reassurance is the only treatment necessary.

Basal cell carcinomas are typically more translucent and feature telangiectasia. A keratotic center is seen in both squamous cell carcinomas and keratoacanthomas. This patient’s lesion lacked the pasted-on appearance and verrucous surface of a seborrheic keratosis.