Superficial epithelioma with sebaceous differentiation is a rare benign cutaneous tumor, with a few cases documented in the literature. It lacks standardized nomenclature and is therefore probably underdiagnosed. We report the case of a 68-year-old man who presented with a pigmented nodule on the forehead. The lesion was fully excised. Histopathologic examination revealed a superficial plate-like epithelial tumor with pushing borders, attached to the overlying epidermis. It was characterized by multilobular proliferation of basaloid to squamous cells with mature sebaceous cells arranged as small clusters or as single cells. Cytologic atypia was absent, and mitotic figures were inconspicuous. Immunohistochemically, tumor cells were positive for cytokeratin 5/6 and negative for Ber-EP4. At 6 months of follow-up, no recurrence was documented. The diagnosis of superficial epithelium with sebaceous differentiation is challenging for both pathologists and dermatologists because of its broad clinical and histologic spectrum, which allows for a wide differential diagnosis.
Saxophone penis is a rare and severe manifestation of penoscrotal elephantiasis, characterized by marked penile deformity resembling a saxophone. It results from chronic lymphatic obstruction and progressive fibrosis secondary to long-lasting inflammation, most commonly in the course of hidradenitis suppurativa. Hidradenitis suppurativa is a chronic inflammatory dermatosis leading to the formation of painful nodules, abscesses, sinus tracts, and scarring, predominantly affecting intertriginous areas such as the axillae, groin, and perineum. We describe 2 cases of saxophone penis secondary to advanced penoscrotal hidradenitis suppurativa. The first patient was a 33-year-old man with a 1.5-year history of untreated disease, presenting with severe penoscrotal lymphedema and penile deformity requiring surgical intervention. The second was a 58-year-old man with a 20-year history of progressive hidradenitis suppurativa and massive penoscrotal involvement. Both patients experienced substantial physical and psychological burden, highlighting the importance of early recognition, appropriate systemic treatment, and multidisciplinary management.
A 55-year-old man presented to dermatologic ambulatory care for dermoscopic evaluation of a small facial lesion. Apart from it, which turned out to be actinic keratosis, multiple oval hypopigmented macules were present on his trunk, resembling regressed Sutton nevi, along with one atypical melanocytic lesion. On dermoscopy, this lesion showed asymmetry of structure, color, and border, as well as blue-grey areas and angulated lines, with no halo. The lesion was excised and diagnosed as superficial spreading melanoma in situ. The presence of Sutton nevi may be associated with several conditions, especially vitiligo, but also thyroid diseases, malignancies, or may occur after immunotherapy. However, surrounding hypopigmentation has also been described in melanoma.
