Case Number : Case 1559 - 16 June Posted By: Guest

?Perianal Primary Chancre   ?Crohn Disease? It seems there are many plump endothelial cells between the dense plasma cell infiltrate, and some subtle granuloma that point more to primary syphilis...

Decapitation, plasma cells. thinking of syringocystadenoma papilliferum

I agree that syphilis should be discarded in a case like this, there is some epidermal hyperplasia massive presence of plasma cells, etc. Spirochete staining is a must, I think it will be positive. Syringocystadenoma papiliferum also crossed my mind but is not the typical image (the papiliferum part is not present and the plasma cells are surrounding the lesion) and epithelium looks reactive maybe because of the inflammatory infiltrate. But agree with the three excellent differentials of the colleges.

I called it a median raphe cyst.