Eccrine Spiradenoma of the Scalp

A 57-year-old woman presented with a solitary, firm, red nodule on the scalp [Figure 1]. The lesion had been present for the last 11 years and was associated with intermittent mild discomfort, without rapid growth or ulceration. Examination revealed a well-circumscribed, non-tender nodule with no surface changes. The clinical differential diagnoses included cylindroma, hidradenoma, pilomatricoma, and solitary trichoepithelioma. The lesion was excised and sent for histopathological evaluation. Microscopy revealed a multinodular basophilic tumor in the dermis, extending into the subcutis [Figure 2a]. It was composed of two distinct cell populations: central large pale cells and peripheral basaloid cells. Hyaline basement membrane material and intra-tumoral lymphocytes were also noted, consistent with eccrine spiradenoma [Figure 2b]. The postoperative course was uneventful, and the wound healed completely after suture removal.[1]Figure 1: Well-defined, firm, nontender nodule without overlying skin changes on the scalpFigure 2: Histopathological section of the excised lesion showing (a) a well-circumscribed, multinodular basophilic tumor centered in the dermis with extension into the subcutis (Hematoxylin and eosin, 100x); (b) tumor is composed of two distinct cell populations: central large cells and peripheral basaloid cells, along with deposition of hyaline basement membrane material and intratumoral lymphocytes (Hematoxylin and eosin, 200x)Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed. Authors’ contributions We confirm that all authors have read and approved the manuscript for submission. All authors meet authorship criteria, and the manuscript represents honest work. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. Use of artificial intelligence (AI) The preparation of this manuscript was carried out entirely by the authors without the use of artificial intelligence technologies.