Syringocystadenoma Papilliferum arising from a nevus sebaceus mimicking squamous cell carcinoma in a Filipino female: A case report

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.

Efficacy and safety of sunflower oil for mild to moderate plaque-type psoriasis: A double-blind, randomized controlled trial

@#<p style="text-align: justify;"><strong>Background:</strong> Psoriasis is a chronic, complex, inflammatory disease that needs safe and effective treatment options to decrease its disease burden.</p><p style="text-align: justify;"><strong>Objectives:</strong> To determine the efficacy and safety of sunflower oil in mild to moderate plaque-type psoriasis at the outpatient department of a tertiary hospital.</p><p style="text-align: justify;"><strong>Methods:</strong> 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.</p><p style="text-align: justify;"><strong>Results:</strong> 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.</p><p style="text-align: justify;"><strong>Conclusion:</strong> This study showed that sunflower oil is effective and safe in mild to moderate plaque-type psoriasis.</p>