Practical Dermoscopy
Tumor Collision Over Sebaceous Nevus: Clues for Dermoscopic Diagnosis
Tumores de colisión sobre nevus sebáceo: claves para su diagnóstico dermatoscópico
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Lobato-Berezo, P. Aguilera-Peiró, R.M. Pujol" "autores" => array:3 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Lobato-Berezo" "email" => array:1 [ 0 => "allobe@hotmail.es" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "P." "apellidos" => "Aguilera-Peiró" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "R.M." "apellidos" => "Pujol" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Unidad de Dermatología, Hospital del Mar, Barcelona, España" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Dermatología, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Barcelona, España" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Dermatología, Hospital Clinic Barcelona, Barcelona, España" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tumores de colisión sobre nevus sebáceo: claves para su diagnóstico dermatoscópico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 695 "Ancho" => 800 "Tamanyo" => 68106 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Two large asymmetric blue-gray ovoid nests, one containing thick vessels and a symmetric erythematous lesion with exophytic papillary structures and dotted and linear vessels in the interior.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 38-year-old man presented with a waxy congenital plaque on his forehead that had undergone changes in the past few years. These changes included the development of several bluish nodules within the plaque. The texture of these nodules had also varied. Physical examination showed a well-delimited yellowish plaque measuring 3<span class="elsevierStyleHsp" style=""></span>cm containing 2 blue nodules and surrounded by several warty, papillomatous areas (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Dermoscopic examination showed a white-yellowish cobblestone pattern with 2 large, asymmetric blue-gray ovoid nests, the largest of which contained thick vessels. It also showed a symmetric erythematous lesion with exophytic papillary structures and polymorphous (dotted and linear) vessels (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The histologic images are shown in <a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Diagnosis: Collision tumors or tumors composed of trichoblastoma and syringocystadenoma papilliferum on a sebaceous nevus.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Sebaceous nevus is a benign congenital hamartoma that usually affects the scalp or face.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> It is well known that secondary tumors with a predominant line of differentiation (follicular, sebaceous, or apocrine) can arise in sebaceous nevi. These tumors are observed in approximately 10% to 20% of cases. The 2 main secondary tumors associated with sebaceous nevus are trichoblastoma and syringocystadenocarcinoma papilliferum, which are generally benign. Malignant tumors can also develop but they are rare. The most common type is basal cell carcinoma. Few studies have described the dermoscopic features of lesions arising in sebaceous nevus. Zaballos et al.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> described the main characteristics of these tumors in a review of 58 cases. Basal cell carcinomas tend to appear as large, blue-gray, asymmetric ovoid nests possibly containing blue-gray globules. Trichoblastomas, by contrast, tend to have more symmetric, homogeneous ovoid nests occupying the entire lesion. Basal cell carcinomas tend to start with characteristic arborizing telangiectasias. Trichoblastoma overlying a sebaceous nevus has also been described as an irregular blue-gray area with a linear vascular pattern or arborizing telangiectasias with white structures.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> Syringocystadenocarcinoma papilliferum shows a symmetric pattern formed by an exophytic papillary structure with erythema, ulceration, and atypical vessels (coma, hairpin, horseshoe-shaped, and atypical irregular, glomerular, dotted, and polymorphous) vessels.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> On occasions, this erythematous background may be divided by whitish linear structures that demarcate lobules containing different types of vessels.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> Apocrine hidrocystomas appear as symmetric homogeneous areas with arborizing telangiectasias.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Dermoscopy is one of the most accurate in vivo tools available for guiding diagnosis prior to surgery. It is also useful for monitoring disease progression and enabling the early detection of tumors arising in sebaceous nevi. More descriptive studies of the characteristics of these tumors are needed to aid diagnosis. Histologic examination, however, provides the greatest accuracy and is the gold standard diagnostic tool, as the entities can sometimes mimic each other on dermoscopy.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Lobato-Berezo A, Aguilera-Peiró P, Pujol RM. Tumores de colisión sobre nevus sebáceo: claves para su diagnóstico dermatoscópico. Actas Dermosifiliogr. 2018;109:647–648.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 675 "Ancho" => 675 "Tamanyo" => 96440 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Yellowish plaque on the forehead containing areas with an irregular texture and blue nodules.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 695 "Ancho" => 800 "Tamanyo" => 68106 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Two large asymmetric blue-gray ovoid nests, one containing thick vessels and a symmetric erythematous lesion with exophytic papillary structures and dotted and linear vessels in the interior.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 718 "Ancho" => 900 "Tamanyo" => 151273 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Trichoblastoma and syringocystoadenoma papilliferum in a sebecaeous nevus (numerous structures similar to follicle germinal cells with cystic invaginations composed of 2 layers of epithelial cells (hematoxylin and eosin, original magnification ×10).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trichoscopy: The best auxiliary tool in the evaluation of nevus sebaceous" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B.S. 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Gököz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Australas J Dermatol" "fecha" => "2015" "volumen" => "56" "paginaInicial" => "53" "paginaFinal" => "54" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermoscopic aspects of syringocystadenoma papilliferum associated with nevus sebaceous [Article in English, Portuguese]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.B. Bruno" 1 => "F.N. Cordeiro" 2 => "E. Soares Fdo" 3 => "G.H. Takano" 4 => "L.S. Mendes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "An Bras Dermatol" "fecha" => "2011" "volumen" => "86" "paginaInicial" => "1213" "paginaFinal" => "1216" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22281917" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multiple pigmented trichoblastomas and syringocystadenoma papilliferum in naevus sebaceous mimicking a malignant melanoma: A clinical dermoscopic-pathological case study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "V. De Giorgi" 1 => "D. Massi" 2 => "E. Trez" 3 => "B. Alfaioli" 4 => "P. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 18 | 8 | 26 |
| 2024 October | 118 | 54 | 172 |
| 2024 September | 99 | 138 | 237 |
| 2024 August | 119 | 72 | 191 |
| 2024 July | 81 | 59 | 140 |
| 2024 June | 99 | 139 | 238 |
| 2024 May | 94 | 64 | 158 |
| 2024 April | 84 | 44 | 128 |
| 2024 March | 79 | 37 | 116 |
| 2024 February | 73 | 47 | 120 |
| 2024 January | 67 | 43 | 110 |
| 2023 December | 89 | 16 | 105 |
| 2023 November | 107 | 30 | 137 |
| 2023 October | 96 | 25 | 121 |
| 2023 September | 98 | 37 | 135 |
| 2023 August | 84 | 34 | 118 |
| 2023 July | 93 | 37 | 130 |
| 2023 June | 86 | 28 | 114 |
| 2023 May | 119 | 32 | 151 |
| 2023 April | 71 | 22 | 93 |
| 2023 March | 100 | 26 | 126 |
| 2023 February | 79 | 33 | 112 |
| 2023 January | 62 | 39 | 101 |
| 2022 December | 85 | 42 | 127 |
| 2022 November | 67 | 30 | 97 |
| 2022 October | 51 | 23 | 74 |
| 2022 September | 64 | 35 | 99 |
| 2022 August | 46 | 47 | 93 |
| 2022 July | 39 | 47 | 86 |
| 2022 June | 33 | 34 | 67 |
| 2022 May | 115 | 51 | 166 |
| 2022 April | 108 | 49 | 157 |
| 2022 March | 99 | 63 | 162 |
| 2022 February | 53 | 22 | 75 |
| 2022 January | 127 | 48 | 175 |
| 2021 December | 86 | 44 | 130 |
| 2021 November | 57 | 55 | 112 |
| 2021 October | 64 | 60 | 124 |
| 2021 September | 60 | 40 | 100 |
| 2021 August | 66 | 44 | 110 |
| 2021 July | 64 | 32 | 96 |
| 2021 June | 46 | 37 | 83 |
| 2021 May | 57 | 58 | 115 |
| 2021 April | 102 | 89 | 191 |
| 2021 March | 79 | 51 | 130 |
| 2021 February | 59 | 51 | 110 |
| 2021 January | 45 | 51 | 96 |
| 2020 December | 43 | 42 | 85 |
| 2020 November | 41 | 43 | 84 |
| 2020 October | 32 | 16 | 48 |
| 2020 September | 40 | 30 | 70 |
| 2020 August | 28 | 24 | 52 |
| 2020 July | 29 | 24 | 53 |
| 2020 June | 42 | 45 | 87 |
| 2020 May | 24 | 24 | 48 |
| 2020 April | 22 | 19 | 41 |
| 2020 March | 30 | 10 | 40 |
| 2020 February | 2 | 0 | 2 |
| 2019 October | 206 | 0 | 206 |
| 2019 April | 1 | 0 | 1 |
| 2019 February | 5 | 0 | 5 |
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