Thanks for your query.
Going by the pictures sent by you, the first differential diagnosis that comes to mind is Vitiligo but as that has been ruled out by biopsy it’s very unlikely. Still I would request you to get the biopsy examined once again.
Sebaceous hyperplasia found in areolar area is nothing abnormal. The change of color in the skin of areola has nothing to do with sebaceous hyperplasia. Change of color is caused due to the damage of melanocytes in epidermis. A rare condition that might cause such a picture is collection of fat droplets - xanthelasma and can be attributed to sebum glands.
Biopsy alone can give the best answer in your case and should be evaluated by a competent Dermato-pathologist.
Hope that this information helps and hope that you will get better soon.
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Dr. Rohit Batra
Thank you Doctor. When you look closely the pattern resembles Fordyce spots that I have on my upper lip and this is the theory of my of my dermatologist. He also got a second opinion from the dermato-pathologist who examined the biopsy (he saw me in person as well). Are there treatments or options for fordyce spots?