Dermoscopy case of the month
Use of dermoscopy in the diagnosis of sebaceoma

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Clinical presentation

An 81-year-old man presented for a routine clinical dermatologic examination. The examination revealed a 15-mm, pink, well demarcated nodule on the sacral region (Fig 1).

Dermoscopic appearance

Dermoscopy revealed a lesion with a homogeneous, translucent yellow-pinkish area, with some ulcerations in the middle and arborizing telangiectasias starting from the periphery that ramify towards the center of the lesion (Fig 2), suggestive of rippled pattern sebaceoma.1

High-frequency ultrasound appearance

To better discriminate the nature of this lesion, a 22-MHz high-frequency ultrasound (HFUS) examination was performed. HFUS revealed a very superficial, hyporeflective, well delimited oval structure (Fig 3), characterized by a homogeneous echo-poor area compared with the surrounding tissues.

Histologic diagnosis

The histopathologic examination revealed a multinodular tumor with symmetric, well circumscribed lobules in the dermis, partially connected to the epidermis (Fig 4). Lobules were composed of basaloid cells without nuclear atypia or mitotic figures, mixed with sebocytes and sebaceous duct–like structures. Focally, the tumor had a peculiar rippled pattern.2

Key message

The differential diagnosis between sebaceoma and basal cell carcinoma could present some difficulties because both types of lesions

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References (2)

  • M. Nomura et al.

    Dermoscopy of rippled pattern sebaceoma

    Dermatol Res Pract

    (2010)
  • J.L. Troy et al.

    Sebaceoma. A distinctive benign neoplasm of adnexal epithelium differentiating toward sebaceous cells

    Am J Dermatopathol

    (1984)

Cited by (7)

  • Dermoscopy of Adnexal Tumors

    2018, Dermatologic Clinics
    Citation Excerpt :

    Although there are usually other differences in the silhouette of both tumors (sebaceous adenoma usually connects to the epidermis, whereas sebaceoma do not), there are many cases of benign sebaceous neoplasms with overlapping cytologic and architectural features, suggesting a possible morphologic spectrum.12–17 Dermoscopically, differentiating between sebaceous adenoma and sebaceoma is not achievable and 2 main patterns have been described in both lesions.12–17 First, tumors with a central crater are dermoscopically characterized by elongated radial telangiectasias (crown vessels) that embrace an opaque structureless ovoid white-yellow center, which are at times covered by blood crusts.13

  • Sebaceous Neoplasms

    2023, Diagnostics
  • Tumors of the Skin Appendages

    2021, Atlas of Dermatology, Dermatopathology and Venereology: Cutaneous Infectious and Neoplastic Conditions and Procedural Dermatology
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Funding sources: None.

Conflicts of interest: None declared.

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