ORIGINAL ARTICLE Clinical, dermoscopic and reflectance confocal microscopy features of sebaceous neoplasms in Muir–Torre syndrome E. Moscarella, † G. Argenziano, ‡, * C. Longo, ‡ C. Cota, § M. Ardigo `, – V. Stigliano,** L.S. Mete,** P. Donati, § S. Piana, †† V. Silipo, † C. Catricala `, † G. Albertini, ‡ I. Zalaudek ‡‡ † Department of Oncologic Dermatology, San Gallicano Dermatologic Institute, Rome, Italy ‡ Dermatology Unit, Medical Department, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy § Department of Dermatopathology, San Gallicano Dermatologic Institute, Rome, Italy – Department of Dermatology, San Gallicano Dermatologic Institute, Rome, Italy ** Department of Gastroenterology, Regina Elena Cancer Institute, Rome, Italy †† Department of Pathology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy ‡‡ Department of Dermatology, Medical University of Graz; Graz, Austria *Correspondence: G. Argenziano. E-mail: g.argenziano@gmail.com Abstract Background Muir–Torre syndrome (MTS) is an autosomal-dominant disorder characterized by the association of sebaceous tumors or keratoacanthomas with an early onset visceral cancer in the spectrum of Lynch syndrome. Observations A total of 20 sebaceous tumors including 18 sebaceous adenoma and two sebaceomas of six patients with MTS were analysed. Two main clinico-dermoscopic features were observed: (1) clinically pink to white papules ⁄ nodules with a central crater, dermoscopically characterized by radially arranged, elongated crown vessels surrounding opaque structureless yellow areas at times covered by blood crusts (n = 13) and (2), clinically pink to yellow papules ⁄ nodules without a central crater, dermoscopically exhibiting a few, loosely arranged yellow comedo- like globules and branching arborizing vessels (n = 7). Confocal microscopy was available in three sebaceous adenomas and revealed a good histopathologic correlation; sebaceous lobules were composed by clusters of ovoid cells with dark nuclei and bright, highly refractile glistening cytoplasm. They were delimited by a rim of epithelial cells, corresponding to basaloid cells. Conclusions A better characterization of clinical, dermoscopic and confocal microscopy features of sebaceous tumors may improve their recognition and consequently, aid to rise the suspect for MTS. Received: 15 December 2011; Accepted: 7 March 2012 Conflict of interest None. Funding source None. Funding support Dr Elvira Moscarella is currently supported by the Funding support the Italian Ministry of Health Ricerca Finalizzata 2007 (C. Catricala ` ) and ISS-ACC (C. Catricala ` ). Introduction Muir–Torre syndrome (MTS) is an autosomal-dominant disorder characterized by the association of sebaceous gland tumors or keratoacanthomas (KAs) with one or more visceral cancer (VC). 1,2 A diagnosis of MTS can be made when concurrent or sequential sebaceous skin tumors (adenoma, epithelioma or carcinoma) are found together with at least one VC or when a family history of MTS occurs together with a personal history of multiple KAs and visceral malignancies. 1–10 MTS is thought to be a phenotypic variant of Lynch syndrome (LS) 11–14 also known as hereditary non-polyposis colorectal cancer or cancer family syndrome. 15 LS is an autosomal dominant condi- tion with incomplete penetrance, predisposing to colorectal cancer and other malignancies and caused by a germline mutation in one ª 2012 The Authors JEADV 2013, 27, 699–705 Journal of the European Academy of Dermatology and Venereology ª 2012 European Academy of Dermatology and Venereology DOI: 10.1111/j.1468-3083.2012.04539.x JEADV