Sebaceous hyperplasia

Crown vessels are typically seen in sebaceous hyperplasia and are characterized by elongated, blurred telangiectases that embrace centrally located white to yellow lobular structureless areas. The vessels do not usually cross over the central portions of the lesion, and they reveal a radial arrangement. The main differential diagnosis of sebaceous hyperplasia is basal cell carcinoma. The different vascular patterns and vessels arrangements are important clues that help in the distinction between these two entities. More specifically, the branching or arborizing vessels of nodular basal cell carcinoma are bright red, are sharply focused, and often course over the central part of the lesion. Conversely, sebaceous hyperplasia is typified by the presence of crown-like vessels located around the periphery of the lesion that are less bright red and are blurred compared to the vessels observed in basal cell carcinoma.