Introduction:

Histologically speaking, architectural, and cytological features help enable the differentiation between sebaceous carcinoma and benign sebaceous lesions; occasionally, these features are insufficient to determine the benign or malignant nature of a lesion.

Objective:

The objective of the study was to determine p53 and Ki-67 expressions in benign sebaceous lesions and sebaceous carcinoma.

Materials and methods:

Analytical, observational, cross-sectional, and retrospective study conducted on a number of cases of sebaceous hyperplasia, sebaceous adenoma, sebaceoma, and sebaceous carcinoma that were diagnosed at the Dermatology Service of General Hospital of Mexico “Dr. Eduardo Liceaga.” This included the determination of epidemiological, clinical, histopathological, and immunohistochemical features. In addition, descriptive and bivariate statistics were performed.

Results:

Thirty-six cases of sebaceous lesions were included: thirteen (36.1%) cases of hyperplasia, eight (22.2%) cases of adenoma, five (13.9%) cases of sebaceoma, and ten (27.8%) cases of carcinomas. The median age was 57.5 + 15.66 years. Males were mostly affected (52.8%) and the most frequent topography was the face (91.7%). Sebaceous carcinomas exhibited the following traits: asymmetry (p = 0.006), non-circumscribed lesion (p < 0.0001), ulceration (p = 0.024), nuclear atypia (p <0.0001), individual necrosis (p = 0.003), squamous metaplasia (p = 0.017), and higher mitotic index (p = 0.005). Sebaceous carcinomas had a higher percentage of p53 and Ki-67 expression compared to benign sebaceous lesions (p = 0.001 and p = 0.001, respectively) and more frequently expressed p53 > 10% and Ki-67 > 25% (p < 0.0001 and p < 0.0001, respectively).

Conclusion:

p53 expression > 10% and Ki-67 expression > 25% are suggestive of a sebaceous carcinoma diagnosis.