|LETTER TO EDITOR
|Year : 2021 | Volume
| Issue : 1 | Page : 129-130
A painless bump on scalp
Seetharampura Ramamurthy Radhika, Kanathur Shilpa, Leelavathi Budamakuntla
Department of Dermatology, Venerology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
|Date of Submission||23-Jan-2020|
|Date of Decision||15-Apr-2020|
|Date of Acceptance||10-May-2020|
|Date of Web Publication||19-Feb-2021|
Seetharampura Ramamurthy Radhika
No. 12, 1st Cross, Sri Krupa Layout, Abbigere, Chikkabanavara Post, Bengaluru - 560 090, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Radhika SR, Shilpa K, Budamakuntla L. A painless bump on scalp. Clin Dermatol Rev 2021;5:129-30
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 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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Syringocystadenoma papilliferum is a rare adnexal hamartomatous tumor which originates from the apocrine glands. Usually, half of the cases are present at birth, and 1/3rd are present during puberty. 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. 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. Syringocystadenocarcinoma papilliferum is the malignant counterpart of syringocystadenoma papilliferum. 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.
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Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3]