10.5826/dpc.1304a239
text/xml
2160-9381
3377
en
Elizabeth Natalia Quispe Susara
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
dermoscopy
Syringocystadenoma Papilliferum of Eyelid, an Unusual Presentation: A Case Series.
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Research Letter
2023-10-31
2023-03-28
2023-10-31
2024-01-15
e2023239
Dermatol Pract Concept
Elizabeth Natalia Quispe Susara
2023/10/31
10.5826/dpc.1304a239
e2023239
Department of Pathology, Centro Médico Nacional la Raza, Instituto Mexicano del Seguro Social, México City, Mexico
2160-9381
dermoscopy
en
e2023239
Sgouros D, Theofili M, Damaskou V et al. Dermoscopy as a Tool in Differentiating Cutaneous Squamous Cell Carcinoma From Its Variants. Dermatol Pract Concept. 2021; 11(2):e2021050. doi: 10.5826/dpc.1102a50. PMID: 33954021
Syringocystadenoma Papilliferum of Eyelid, an Unusual Presentation: A Case Series.
https://dpcj.org/index.php/dpc/article/download/3377/2399
      Syringocystadenoma Papilliferum of the Eyelid,
          an Unusual Presentation: A Case Series
    Omar Loza-Escutia1, Juan Alberto Godínez-Chaparro2, Rosa María Guevara Castillo3,
          Marissa de Jesús Quintal-Ramírez4, Elizabeth Natalia Quispe Susara4


1 Dermatology service, Hospital General Regional No. 2, Instituto Mexicano del Seguro Social, Mexico City, Mexico
2 Pediatric Dermatology Service, Centro Médico Nacional la Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
3 Department of Dermatology, Centro Médico Nacional la Raza, Instituto Mexicano del Seguro Social, México City, Mexico
4 Department of Pathology, Centro Médico Nacional la Raza, Instituto Mexicano del Seguro Social, México City, Mexico



Key words: syringocistadenoma papilliferum, adnexal tumor, eyelid, dermoscopy
Citation: Loza-Escutia O, Godínez-Chaparro JA, Guevara Castillo RM, Quintal-Ramírez MJ, Quispe Susara EN. Syringocystadenoma
Papilliferum of the Eyelid, an Unusual Presentation: A Case Series. Dermatol Pract Concept. 2023;13(4):e2023239. DOI: https://doi.org/10
.5826/dpc.1304a239
Accepted: May 1, 2023; Published: October 2023
Copyright: ©2023 Loza-Escutia et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Omar Loza-Escutia, Current Address: Tuxpan 28, 202-A Roma Sur, Cuauhtémoc, CP:06760 Mexico City, Mexico.
Phone: 52 55 43 42 02 18 E-mail: omar_loza7@hotmail.com




Introduction                                                             vascular structures surrounded by a whitish halo (Figure 1B).
                                                                         Histologic examination demonstrated several cystic and
                                                                         ­
Syringocystadenoma papilliferum (SCAP) is a benign adnexal               ductal invaginations spreading from the epidermis and pap-
tumour originated from the apocrine and eccrine glands [1].              illary projections covered by a double row of epithelial cells
It may grow de novo or from another preexisting adnexal                  (Figure 1C), the stroma had countless plasma cells. It was
tumor.1 The eyelid topography is extremely unusual [2].                  diagnosed as a SCAP and completely resected.


Case Presentation                                                        Case #2
                                                                         A 51-year-old Mexican male presented a lesion of 10 years
Case #1                                                                  of evolution localized on the lateral margin of the left lower
An 80-year–old Mexican female presented a lesion of 3 years              eyelid. He had an itchy, erythematous, rough, solitary nod-
of evolution on the medial margin of the left u
                                              ­ pper eyelid.             ule, measuring 0.8 x 0.5 cm (Figure 2A). Dermoscopic and
She had an itchy, coarse, crusted, solitary nodule, measur-              histologic findings observed in this case were like the previ-
ing 0.6 x 0.3 cm (Figure 1A). A dermoscopic examina-                     ous one (Figure 2 B and C). A SCAP was diagnosed, and the
tion (10x) revealed a lesion with monomorphous septated                  patient was sent to plastic surgery for its resection.




Research Letter | Dermatol Pract Concept. 2023;13(4):e2023239                                                                          1
Figure 1. Case #1. (A) Clinical image (black arrow). (B) Dermoscopic image (10x): vascular structures surrounded by whitish halo (black
arrow). (C) Histopathology: invaginations (black arrow) and papillomatous projections (green arrow). (D) Double row of epithelial cells
(white arrow), plasma cells infiltration in the stroma (blue arrow) and decapitation secretion (red arrow).



Conclusions                                                          vessels with predominance of hairpin and coma pattern [2].
                                                                     The diagnosis confirmation is made by histopathology [1].
SCAP may be presented on any part of the body and oc-                    Some other tumors must be differentiated from SCAP,
casionally affects the eyelid skin [1]. SCAP is a lesion pre-        such as warts, seborrheic keratoses, basal cell carcinomas
sented more frequently in women (62%) and the mean age               and squamous cell carcinomas. There are some dermoscopic
at diagnosis is 43.9 years [1]. The size of the lesion often         features that may help differentiate SCAP from these enti-
ranges from 4 mm to 25 mm, with a median of 7 mm [1].                ties: a) warts exhibit papillary growths, bleeding, dotted and
Comparatively, our patient lesions sizes were close the re-          linear vessels, b) seborrheic-keratoses present fissures and
ported median. The frequency of this localization is higher          ridges, comedo-like openings, milia like cysts and hairpin
on the upper right eyelid on the lateral margin [1]. In both         blood vessels surrounded by whitish halo, c) basal cell carci-
our cases, lesions were found on the left eyelids, albeit at         nomas reveal arborizing and linear vessels running parallel
different palpebral topography.                                      to each other and perpendicular to the eyelid margin; dots
    Dermoscopic descriptions of SCAP are scarce, neverthe-           and globules were seen in pigmented lesions, d) squamous
less, and concordantly with our cases, exophytic papillary           cell carcinomas show glomerular or linear vessels, central
structures can be appreciated, surrounded by a whitish halo,         keratin plugs, erosions and ulcerations above a white, pink
central ulcerations, or erosions with crusts; polymorphous           or mixed background [3-6].

2                                                                        Research Letter | Dermatol Pract Concept. 2023;13(4):e2023239
Figure 2. Case #2. (A) Clinical image (black arrow). (B) Dermoscopic image (10x): septated vascular structures surrounded by whitish halo
(black arrow). (C) Histopathology: ductal invaginations from epidermis (black arrow) and papillary projections (yellow arrow). (D) Double
row of epithelial cells (black arrow) with a dense infiltration of plasma cells in the stroma (yellow arrow) and a secretion through decapita-
tion (red arrow).



    Considering that the malignancy transformation risk                        DOI: 10.5826/dpc.0801a07. PMID: 29445572. PMCID:
has been reported as 3.7%, its complete excision is recom-                     PMC5808369.
                                                                          3.   Al Rudaisat M, Cheng H. Dermoscopy Features of Cutaneous
mended [1].
                                                                               Warts. Int J Gen Med. 2021; 14:9903-9912. DOI: 10.2147/
    SCAP is a rare neoplasia which very rarely presents on
                                                                               IJGM.S335276. PMID: 34938109. PMCID: PMC8687684.
the eyelids. Dermoscopic exploration can shed useful insight              4.   Minagawa A. Dermoscopy-pathology relationship in seborrheic ker-
when assessing all the relevant differential diagnoses.                        atosis. J Dermatol. 2017; 44(5):518-524. DOI: 10.1111/1346-8138
                                                                               .13657. PMID: 28447350.
                                                                          5.   Vaccari S, Barisani A, Schiavi C, et al. Basal cell carcinoma of the
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Research Letter | Dermatol Pract Concept. 2023;13(4):e2023239                                                                                   3
