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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 2002 - 07 Feb 2018 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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60 year old woman with large lesion on scalp that has been recently growing.

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syringocystadenoma papilliferum arising in a sebaceous nevus

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Fronds with papillation

Secretion with decapitation

Plasma cells in the corium

Syringocystadenoma papilliferum !

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Uma Sundram


You bet! syringocystadenoma papilliferum in a nevus sebaceus.

Some take home points about this particular case: 1) this can be diagnosed at ANY age (i.e., the nevus sebaceus part). Just watch out for it and insist on seeing those endophytic fronds with plasma cells. We had to do a deeper biopsy to really nail the diagnosis although we suspected it on the initial biopsy. 2) The top of a long standing lesion can have acanthosis and hyperkeratosis, and mimic epithelial tumors. Insist on a deeper biopsy if you cannot make a definitive diagnosis on the first try.

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