Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2025;15(2):5393 1

Dermoscopy of de novo Syringocystadenoma 
Papilliferum in Dark and Fair Skin

Noemi Plozner1, Maitha Abdulla Aljuwaied 2, Esmaeel AlSayed Mohamed Almarzooqi2, 
Mohammed Ahmed2, Giuseppe Stinco1, Enzo Errichetti1

1 Institute of Dermatology, Department of Medical Area, University of Udine, Italy

2 Dubai health dermatology and aesthetic center, Dubai, UAE, University of Sharjah, Sharjah, UAE

Citation: Plozner N, Abdulla Aljuwaied M, AlSayed Mohamed Almarzooqi E, et al. Dermoscopy of de novo Syringocystadenoma 
Papilliferum in Dark and Fair Skin. Dermatol Pract Concept. 2025;15(2):5393. DOI: https://doi.org/10.5826/dpc.1502a5393

Accepted: December 10, 2024; Published: April 2025

Copyright: ©2025 Plozner 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: Noemi Plozner, MD, Institute of Dermatology, Department of Medicine, University of Udine; Piazzale Santa Maria 
della Misericordia, 15. 33100 – Udine, Italy. E-mail: noemiplozner@hotmail.it

Cases Presentations

We present the cases of two boys, aged 11 years (Case 1) 

and one year (Case 2), showing phototypes IV and II, re-

spectively. Both of them had a history of a slowly enlarging 

lesion on the chest (Case 1) and intergluteal cleft (Case 2), 

first noticed at birth. Physical examination revealed con-

fluent, well-circumscribed papules ranging from brown to 

purple in color (Case 1) and skin-colored to pink (Case 2)   

(Figure 1A-B). On dermoscopy, both cases showed concentric 

structures with a central round/polygonal brown area sur-

rounded by white halo, with white-purple/pink-white back-

grounds and peripheral polymorphous vessels, which were 

less evident in the dark-skinned patient (Figure 1C-D). In both 

instances, histological assessment displayed cystic spaces lined 

by eccrine epithelium, containing amorphous debris, along 

with papillary epithelial hyperplasia (Figure 1E), consistent 

with a diagnosis of syringocystadenoma papilliferum (SCAP).

Teaching point

SCAP is a rare benign adnexal tumor of apocrine/eccrine 

differentiation developing in nevus sebaceous or de novo 

and presenting at birth or during puberty [1]. Limited data 

are available on dermoscopy of de novo SCAP. In our cases, 

we noted that the skin tone may impact either color back-

ground or visualization of vascular structures, which are 

more evident in fair skin. De novo SCAP displays some 

dermoscopic clues regardless of the phototype, including 

concentric structures consisting of a central round/polygo-

nal brown area of ulceration/crusting surrounded by white 

halo, histologically corresponding to the eroded/crusted 

surface of the cystic invagination of the tumor and the hy-

perplastic eccrine epithelium lining the cystic structures, 

respectively [2].



2 Image Letter | Dermatol Pract Concept. 2025;15(2):5393

Figure 1. Clinical image of syringocystadenoma papilliferum in two boys of phototype IV (A; Case 1) and II (B; Case 2) showing  

(A) brown to purple papules on the chest and (B) skin-colored-to-pink grouped/confluent papules on the intergluteal cleft. (C, D) 

Dermoscopy of Case 1 and Case 2 show concentric structures with a central round/polygonal brown area (arrows) surrounded by 

white halo (arrowheads). (C) Case 1 shows a white-purple background and (D) Case 2 shows pink-white background and periph-

eral polymorphous vessels, which were more evident. (E) Representative histological image (H&E; magnification ×40) reveals cystic 

spaces lined by eccrine epithelium (arrowheads) whose surface shows erosions/crusting (arrows), corresponding to the white halo and 

round/polygonal brown area seen on dermoscopy, respectively. Amorphous debris in the cystic spaces along with papillary epithelial 

 hyperplasia are also visible on histology.



Image Letter | Dermatol Pract Concept. 2025;15(2):5393 3

References

1. Zaballos P, Serrano P, Flores G, et al. Dermoscopy of tumours 

arising in naevus sebaceous: a morphological study of 58 cases. 

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2. Dash S, Nayak AK, Sethy M, Palit A, Behera B. Dermoscopic 

findings of de novo syringocystadenoma papilliferum. Indian 

J Dermatol Venereol Leprol. 2021 Mar-Apr;87(2):278-280.  

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