Dermatoscopic pattern of a spiradenoma
Keywords: dermatoscopy; spiradenoma; adnexal neoplasm
Citation: Tschandl P. Dermatoscopic pattern of spiradenoma. Dermatol Pract Conc. 2012;2(4):9. http://dx.doi.org/10.5826/dpc.0204a09.
History: Received: April 4, 2012. Accepted: July 3, 2012. Published: October 31, 2012
Copyright: ©2012 Tschandl. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Competing interests: The authors have no conflicts of interest to disclose.
Corresponding Author: Philipp Tschandl, M.D., Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Waahringer Gürtel 18-20, 1090 Vienna, Austria. Tel. 43.1.40400.7700; Fax. 43.1.408.1928. E-mail: firstname.lastname@example.org
Dermatoscopic features of spiradenoma-a benign adnexal neoplasm-have not been described. We present a case of spiradenoma occurring on the occipital scalp (Figure 1A, 1B) that showed a structureless pattern and blue clods on dermatoscopy. The vascular pattern of serpentine, branched vessels (Figure 2) in combination with blue clods suggest a basal cell carcinoma (BCC) . However, the blue clods in BCC represent nests of pigmented trichoblasts, whereas in this case of spiradenoma the blue clods correspond to hemorrhage, a frequent finding in spiradenoma. This example also demonstrates that branched vessels seen by dermatoscopy are not specific and that they can be found in any kind of adnexal neoplasm, not only in BCC.
Figure 1. (A) Clinical picture of the spiradenoma on the scalp. (B) Clinical closeup image. [Copyright: ©2012 Tschandl.]
Figure 2. Dermatoscopically, blue and orange clods as well as branched vessels can be seen. [Copyright: ©2012 Tschandl.]
Figures 3 and 4 show the histopathologic images of this tumor. One can see large aggregations containing two cell populations, small basaloid cells on one side and large cuboidal cells on the other, and a prominent PAS-positive eosinophilic band is visible at the periphery of the aggregations. The latter feature is reminiscent of a cylindroma but the aggregates of cells are too large. Cylindroma-like features may be encountered in spiradenomas and sometimes these two entities occur together suggesting a common origin of these two adnexal neoplasms.
Figure 3. Histopathologic image at scanning magnification reveals large aggregations of epithelial cells in the dermis and a hemorrhage in the deep reticular dermis. [Copyright: ©2012 Tschandl.]
Figure 4. The aggregations in the dermis are made up of two cell populations, small basaloid cells on one side and large cuboidal cells on the other, and a prominent PAS-positive eosinophilic band is visible at the periphery of the aggregations. [Copyright: ©2012 Tschandl.]