Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2022;12(1):e2022012 1

Protrusions Within a Pink-Yellow Plaque
Csongor Németh1, Melánia Pozsgai1, Rolland Gyulai1, Zsuzsanna Lengyel1

1 Department of Dermatology, Venerology and Oncodermatology, Medical School, Clinical Center - University of Pécs, Pécs, Hungary

Citation: Németh C, Pozsgai M, Gyulai R, Lengyel Z. Protrusions within a pink-yellow plaque. Dermatol Pract Concept. 
2022;12(1):e2022012. DOI: https://doi.org/10.5826/dpc.1201a12

Accepted: April 29, 2021; Published: January 2022

Copyright: ©2022 Németh 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: Zsuzsanna Lengyel MD, PhD. Department of Dermatology, Venerology and Oncodermatology,  
Medical School, Clinical Center - University of Pécs, Hungary. E-mail: lengyel.zsuzsanna@pte.hu

Case Presentation

A 74-year-old woman with a history of several skin tumors 

was referred to our center. She complained of a lesion localized 

on the right flank, growing for 15 months. Upon examination, 

a 75 mm × 30 mm pinkish-yellowish plaque was observed. 

Within the lesion, three red, firm, keratotic papules were seen 

(Figure 1A). Dermoscopy showed yellow globules with indis-

tinct borders on a whitish-erythematous background. In the 

yellowish structures, polymorphous vessels consisting of  linear 

irregular vessels and curved vessels were seen. Within the pap-

ules hairpin, coiled vessels were present (Figure 1, B-D).

Due to the large size, an incisional biopsy was performed. 

Histopathology revealed the collision of an in-situ squamous 

cell carcinoma and superficial sebaceous carcinoma (SC). 

The  lesion was excised with safety margin. Pathology 

 confirmed the previous diagnosis. 

Teaching point

Sebaceous carcinoma tends to mimic squamous and basal 

cell carcinomas. The presence of yellowish structures and 

polymorphous vessels are features suggestive of SC. Some 

suggest that extraocular SC might originate from preexisting 

intraepidermal squamous neoplasia [1,2].

Informed consent: Written informed consent for publica-

tion of clinical details and clinical images was obtained from 

the patient.



2 Image Letter | Dermatol Pract Concept. 2022;12(1):e2022012

References

1. Horimoto K, Kato J, Sumikawa Y, et al. Dermoscopic features 

distinctive for extraocular sebaceous  carcinoma. J Dermatol. 

2018;45(4):487–490. DOI: 10.1111/1346-8138.14170. PMID: 

29235655

Figure 1. (A) Clinical picture of the lesion. (B-D) Dermoscopy demonstrated white-pink areas with yellow structures throughout the lesion 

with polymorphous vessels (arrows)

2. Kogame T, Ohe S, Yamazaki F, Okamoto H, Kiyohara T. Extra-

ocular sebaceous carcinoma accompanied by invasive squamous 

cell carcinoma: The first case report and consideration of histo-

genesis. J Dermatol. 2018;45(4):501–504. DOI: 10.1111/1346 

-8138.14196. PMID: 29266386.