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April 1992

A Painlessly Enlarging Scalp Nodule

Author Affiliations

Pasadena (Tex) Dermatology Clinic and Department of Dermatology, Baylor College of Medicine, Houston, Tex

Arch Dermatol. 1992;128(4):547-548. doi:10.1001/archderm.1992.01680140127017

REPORT OF A CASE  An asymptomatic papule was discovered on the scalp of a 36-year-old woman by her hairdresser. During the subsequent 4 months, the lesion continued to enlarge and would occasionally bleed when traumatized. The 5-mm nodule had a flesh-colored papillary surface, was nontender, and was located on the vertex of the scalp (Fig 1). The woman was otherwise healthy; her only medication was an oral contraceptive that she had been using for several years.An excisional biopsy specimen for histopathologic evaluation and treatment was obtained (Figs 2 and 3). The sections were stained with periodic acid—Schiff (Figs 4 and 5) and were examined under low and high power.What is your diagnosis?

DIAGNOSIS:  Eccrine acrospiroma.

HISTOPATHOLOGIC FINDINGS  Sharply well-circumscribed epithelial lobules were found in the specimen, extending throughout the entire thickness of the dermis. Clear-cell nests were found in some of these proliferations.

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