Comment on: Basal cell carcinoma in a nevus sebaceous of the scalp

We read with great interest the recent case report by Carvalho and Silva describing a basal cell carcinoma arising within a nevus sebaceous of the scalp 1 .The authors highlight the clinical progression, histopathological findings, and the importance of excision in adult patients in whom malignant transformation is suspected.We would like to contribute to this discussion by reporting a similar, yet more complex, case.A 69-year-old man was referred to the dermatology department for evaluation of a congenital lesion on the scalp that had shown progressive growth over recent months.Clinical examination revealed a polymorphic plaque with erythematous, orange and violaceous tones, containing nodular and eroded areas (Fig. 1).Two incisional biopsies were performed, both revealing histopathological features typical of nodular basal cell carcinoma.However, in one of the specimens, cystic invaginations of the infundibular epithelium extending into the dermis, lined by a double layer of epithelial cells, were also observed, suggesting the concomitant presence of syringocystadenoma papilliferum.Surgical excision of the lesion was carried out, with closure achieved using a local rotation flap.Histological evaluation of the surgical specimen confirmed the diagnosis of a nevus sebaceous associated with both syringocystadenoma papilliferum and nodular basal cell carcinoma.Complete excision was achieved.