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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Carli" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2003" "volumen" => "149" "paginaInicial" => "1067" "paginaFinal" => "1070" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14632818" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010900000007/v1_201809020417/S1578219018302154/v1_201809020417/en/main.assets" "Apartado" => array:4 [ "identificador" => "19289" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Practical Dermoscopy" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010900000007/v1_201809020417/S1578219018302154/v1_201809020417/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018302154?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 16 | 8 | 24 |
| 2024 Octubre | 118 | 54 | 172 |
| 2024 Septiembre | 99 | 138 | 237 |
| 2024 Agosto | 119 | 72 | 191 |
| 2024 Julio | 81 | 59 | 140 |
| 2024 Junio | 99 | 139 | 238 |
| 2024 Mayo | 94 | 64 | 158 |
| 2024 Abril | 84 | 44 | 128 |
| 2024 Marzo | 79 | 37 | 116 |
| 2024 Febrero | 73 | 47 | 120 |
| 2024 Enero | 67 | 43 | 110 |
| 2023 Diciembre | 89 | 16 | 105 |
| 2023 Noviembre | 107 | 30 | 137 |
| 2023 Octubre | 96 | 25 | 121 |
| 2023 Septiembre | 98 | 37 | 135 |
| 2023 Agosto | 84 | 34 | 118 |
| 2023 Julio | 93 | 37 | 130 |
| 2023 Junio | 86 | 28 | 114 |
| 2023 Mayo | 119 | 32 | 151 |
| 2023 Abril | 71 | 22 | 93 |
| 2023 Marzo | 100 | 26 | 126 |
| 2023 Febrero | 79 | 33 | 112 |
| 2023 Enero | 62 | 39 | 101 |
| 2022 Diciembre | 85 | 42 | 127 |
| 2022 Noviembre | 67 | 30 | 97 |
| 2022 Octubre | 51 | 23 | 74 |
| 2022 Septiembre | 64 | 35 | 99 |
| 2022 Agosto | 46 | 47 | 93 |
| 2022 Julio | 39 | 47 | 86 |
| 2022 Junio | 33 | 34 | 67 |
| 2022 Mayo | 115 | 51 | 166 |
| 2022 Abril | 108 | 49 | 157 |
| 2022 Marzo | 99 | 63 | 162 |
| 2022 Febrero | 53 | 22 | 75 |
| 2022 Enero | 127 | 48 | 175 |
| 2021 Diciembre | 86 | 44 | 130 |
| 2021 Noviembre | 57 | 55 | 112 |
| 2021 Octubre | 64 | 60 | 124 |
| 2021 Septiembre | 60 | 40 | 100 |
| 2021 Agosto | 66 | 44 | 110 |
| 2021 Julio | 64 | 32 | 96 |
| 2021 Junio | 46 | 37 | 83 |
| 2021 Mayo | 57 | 58 | 115 |
| 2021 Abril | 102 | 89 | 191 |
| 2021 Marzo | 79 | 51 | 130 |
| 2021 Febrero | 59 | 51 | 110 |
| 2021 Enero | 45 | 51 | 96 |
| 2020 Diciembre | 43 | 42 | 85 |
| 2020 Noviembre | 41 | 43 | 84 |
| 2020 Octubre | 32 | 16 | 48 |
| 2020 Septiembre | 40 | 30 | 70 |
| 2020 Agosto | 28 | 24 | 52 |
| 2020 Julio | 29 | 24 | 53 |
| 2020 Junio | 42 | 45 | 87 |
| 2020 Mayo | 24 | 24 | 48 |
| 2020 Abril | 22 | 19 | 41 |
| 2020 Marzo | 30 | 10 | 40 |
| 2020 Febrero | 2 | 0 | 2 |
| 2019 Octubre | 206 | 0 | 206 |
| 2019 Abril | 1 | 0 | 1 |
| 2019 Febrero | 5 | 0 | 5 |
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