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LETTER TO EDITOR
Year : 2021  |  Volume : 5  |  Issue : 1  |  Page : 129-130

A painless bump on scalp


Department of Dermatology, Venerology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India

Date of Submission23-Jan-2020
Date of Decision15-Apr-2020
Date of Acceptance10-May-2020
Date of Web Publication19-Feb-2021

Correspondence Address:
Seetharampura Ramamurthy Radhika
No. 12, 1st Cross, Sri Krupa Layout, Abbigere, Chikkabanavara Post, Bengaluru - 560 090, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CDR.CDR_2_20

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How to cite this article:
Radhika SR, Shilpa K, Budamakuntla L. A painless bump on scalp. Clin Dermatol Rev 2021;5:129-30

How to cite this URL:
Radhika SR, Shilpa K, Budamakuntla L. A painless bump on scalp. Clin Dermatol Rev [serial online] 2021 [cited 2021 Apr 18];5:129-30. Available from: https://www.cdriadvlkn.org/text.asp?2021/5/1/129/309753



Sir,

A 20-year-old female presented to us with an asymptomatic solitary swelling in the scalp for 4 years that gradually progressed over years to reach the present size of 1 cm × 1 cm. There was no history of trauma prior to the onset of the swelling and also no history of any spontaneous bleeding/bleeding on trivial touch. On examination, a solitary pink-colored pedunculated papule was noted in the vertex, and on palpation, it was firm in consistency [Figure 1]. The surrounding skin was normal. Syringocystadenoma papilleferum, trichilemmomma, and appendageal tumors were the differential diagnoses that were thought of. Excision biopsy showed cystic downgrowth from the epidermis extending into the dermis, with papillary structures projecting into the lumen of the cyst [Figure 2]a and the cyst lined by bi-layered epithelium with stroma showing dense plasma cell infiltrate [Figure 2]b, which was consistent with syringocystadenoma papilliferum. [Figure 3] is the scanner view of the same slide.
Figure 1: A solitary pedunculated pink-colored papule

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Figure 2: (a) Cystic downgrowth from the epidermis extending into the dermis, with papillary structures projecting into the lumen of the cyst. (b) The cyst is lined by a bi-layered epithelium with stroma showing dense plasma cell infiltrate (H&Ex10)

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Figure 3: Scanner view of the slide

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Syringocystadenoma papilliferum is a rare adnexal hamartomatous tumor which originates from the apocrine glands.[1] Usually, half of the cases are present at birth, and 1/3rd are present during puberty.[2] It has varied clinical presentation de novo or within a nevus sebaceous. Three clinical subtypes have been described – plaque type, linear type, and solitary nodular type.[3] This tumor is clinically characterized by asymptomatic, skin-colored to pink papules, or plaques, most commonly present on the head-and-neck region; however, tumor in other areas, such as vulva, external ear, lower leg, and scrotum, are also reported. Malignant changes such as basal cell carcinoma, squamous cell carcinoma, and ductal carcinoma can be observed, which arise from the precursor lesion like organoid nevi.[4] Syringocystadenocarcinoma papilliferum is the malignant counterpart of syringocystadenoma papilliferum.[5] Histopathology is an accurate option for the diagnosis, and excision is the treatment of choice.

Hence, this is a rare case of syringocystadenoma papilliferum occurring as a solitary pedunculated papule without its usual association – nevus sebaceous.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Al Hawsawi K, Alharazi A, Ashary A, Siddique A. Syringocystadenoma papilliferum: A case report and review of the literature. Case Rep Dermatol 2019;11:36-9.  Back to cited text no. 1
    
2.
Vyas SP, Kothari DC, Goyal VK. Syringocystadenoma papilliferum of scalp: A rare case report. IJSS 2015;2:182-5.  Back to cited text no. 2
    
3.
Shah PA, Singh VS, Bhalekar S, Sudhamani S, Paramjit E. Syringocystadenoma papilliferum: A rare case report with review of literature. J Sci Soc 2016;43:96-8.  Back to cited text no. 3
  [Full text]  
4.
Godkhindi VM, Meshram DP, Deshpande SA, Suvernekar SV. Syringocystadenoma Papilliferum-Case report. IOSR JDMS 2013;5:43-6.  Back to cited text no. 4
    
5.
Sangma MM, Dasiah SD, Bhat V R. Syringocystadenoma papilliferum of the scalp in an adult male-A case report. J Clin Diagn Res 2013;7:742-3.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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