A 77-year-old Japanese woman presented a dome-shaped pinkish nodule on the scalp. Dermoscopy demonstrated yellowish homogeneous ovoid areas with translucent whitish veil and arborizing vessels. No association with Muir-Torre syndrome was found. Histopathology revealed a smooth-bordered neoplasm in the dermis with partial connection to the epidermis. The tumor was composed mainly of germinative cells. The tumor focally showed a typical “rippled pattern”. There were only a few vacuolated cells suggesting sebaceous differentiation. These cells were highlighted with adipophilin antibody. No nuclear atypia or mitotic figures were observed. We regarded the neoplasm as sebaceoma. Dermoscopy demonstrated clearly visualized yellowish homogeneous ovoid areas. This feature usually corresponds to dermal conglomerations of the cells with sebaceous differentiation. However, this case histopathologically showed only limited area with sebaceous differentiation. We presented a case of rippled-pattern sebaceoma and described its dermoscopic features. This was the first report referring to the dermoscopic features of sebaceoma.
A 77-year-old Japanese woman presented with a tumor on the parietal region of the scalp, which had gradually enlarged over the previous several years. Physical examination revealed a dome-shaped faintly pinkish nodule,
A dome-shaped faintly pinkish nodule. The surface of the tumor was covered with yellow papules.
Yellowish homogeneous ovoid areas and arborizing vessels at the periphery of the nodule.
A well-circumscribed, smooth-bordered, and deeply basophilic tumor in the dermis.
The tumor is composed of basaloid cells with deeply basophilic oval nuclei showing a typical rippled pattern.
The cells simulating Verocay bodies are positive for AE1/AE3.
A few sebocytes are seen at the periphery of the tumor nests.
Sebocytes seen at the periphery of the tumor nests are positive with adipophilin.
Sebaceoma, originally described by Troy and Ackerman [
Dermoscopy is now widely used as a tool to diagnose many pigmented and nonpigmented cutaneous lesions. In the present case, dermoscopic examination demonstrated two discriminating features. One was clearly visualized yellowish homogeneous ovoid areas. This feature usually corresponds to dermal conglomerations of the cells with sebaceous differentiation. However, interestingly, this case histopathologically showed only limited area with sebaceous differentiation. The other feature was arborizing vessels at the peripheral area of the nodule. There were no arborizing vessels in the center of the tumor on dermoscopy or on clinical image as described in basal cell carcinoma [
In this report, we presented a case of rippled-pattern sebaceoma and described its intriguing dermoscopic features.