Introduction: Syringocystadenoma papilliferum (SCAP) is a relatively rare benign adnexal skin tumor which can manifest in a variety of clinical forms. Nearly one-third of cases are known to develop within a pre-existing nevus sebaceus (NS). The peculiar feature of this case was the appearance of a large exophytic tumor within a congenital verrucous plaque, which raised the suspicion of a malignant transformation. This is a case of a young Filipino adult with an unusual presentation of syringocystad- enoma papilliferum in a nevus sebaceus mimicking squamous cell carcinoma. Case report: A 27-year-old Filipino female presented a persistently enlarging exophytic pedunculated cribriform tumor within a congenital verrucous plaque on the left temporal area. The tumor started to appear when she was 20 years old. One month prior to consult, it rapidly increased in size and bled on gentle manipulation. She has neither comorbidities nor any family history of a similar condition. Her physical examination was normal, with no palpable lymphadenopathies. The biopsy showed syringo- cystadenoma papilliferum on a nevus sebaceus. She underwent carbon dioxide (CO2 ) laser excision under local anesthesia. The procedure was uneventful and the patient is on regular follow-up and close monitoring for any possible malignant change or recurrence. Conclusion A case of syringocystadenoma papilliferum on a nevus sebaceus mimicking squamous cell carcinoma in a Filipino female treated with carbon dioxide laser excision was presented. The unusual presentation of SCAP can mimic malignancy and histopathologic evaluation is warranted to rule out malignant transformation for proper management.
Tubular Sweat Gland Adenomas

We are presenting a rare case of a 71-year-old Filipino female with the presence of two skin cancers occurring simultaneously in two different regions of the body.

Patient noted symmetrical, erythematous, pruritic, eczematous patches and plaques on her inguinal areas five years prior to consultation. The patient also had a 2-year history of multiple pigmented papules and plaques on the forehead, left jaw, right cheek, lateral canthus of the left eye, and sternal area associated with occasional bleeding.

Skin examination showed symmetrical, irregularly shaped bright red moist plaques with finger-like projections measuring 26 cm x 9 cm on the vulva, inguinal areas, and intergluteal areas. The patient also had multiple pigmented papules and plaques with rolled borders located on the right forehead, lateral canthus of the left eye, right cheek, left jaw, and sternal area with measurements ranging from 0.3 x 0.4 cm to 1.5 x 2.0 cm in size.

Histological examination of the vulvar skin biopsy is signed out as extramammary Paget’s disease with positive immunohistochemical stain for Cytokeratin 7. A skin punch biopsy on the pigmented plaque on the right forehead is signed out as basal cell carcinoma.

This is the first known case of the simultaneous occurrence of extramammary Paget’s disease and basal cell carcinoma on different regions of the body. We speculate that the two tumors in our patient may have developed independently with no causal relationship, but we are attributing the occurrence of the patient’s carcinomas to her old age, prolonged sun exposure, and immunosuppression.

Human ; Female ; Aged: 65-79 Yrs Old ; Carcinoma, Basal Cell ; Carcinoma ; Skin Neoplasms

Background: Psoriasis is a chronic, complex, inflammatory disease that needs safe and effective treatment options to decrease its disease burden.

Objectives: To determine the efficacy and safety of sunflower oil in mild to moderate plaque-type psoriasis at the outpatient department of a tertiary hospital.

Methods: This was an 8-week, single-center, randomized, double-blind controlled trial that compared the efficacy and safety of sunflower oil + placebo cream (Group SO), betamethasone valerate cream + placebo oil (Group BC), sunflower oil + betamethasone valerate cream (Group SOBC) in mild to moderate plaque-type psoriasis. Psoriasis Area Severity Index (PASI) was used to measure the extent of psoriasis by assessing the erythema, induration, scaling, and body surface area involvement. The difference from baseline PASI was recorded. The Dermatology Life Quality Index (DLQI) questionnaire was used to measure the impact of psoriasis on the patient's quality of life.

Results: Fifty-one patients were randomized and blinded to three treatment arms; evaluated at baseline, week 4 and 8. The proportion of patients who achieved PASI ?50 at week 4 was 29% in Group SO, 38% in Group BC, and 60% in Group SO-BC. By week 8, Groups SO and BC achieved 80% while Group SO-BC achieved 93%. There was significant decline of PASI at week 4 and week 8 compared to baseline. The mean percentage change of PASI was highest at Group SO-BC followed by Group BC and lastly Group SO at week 4 and week 8. The mean reduction in score for scaling was significantly higher in Group SO-BC. Mean reduction in induration and erythema was not statistically significant across the three groups. There was 40-50% improvement in DLQI scores in all groups. There were no adverse events.

Conclusion: This study showed that sunflower oil is effective and safe in mild to moderate plaque-type psoriasis.

Sunflower Oil ; Randomized Controlled Trial ; Psoriasis