Nevus sebaceous is a hamartoma with an uneventful course since birth but many benign or malignant tumors are known to develop in about one third of the patients. A 37-year-old woman with asymptomatic hairless raised lesion over the scalp since birth presented with change in the morphology of the lesions associated with itching and irritation since one month. On examination, multiple well-defined hyperpigmented verrucous plaques coalescing with each other were seen over the right parietal scalp associated with alopecia. A single well-defined soft skin-colored cystic swelling of size 1 × 2 cm was seen interspersed within the plaque. After a clinical diagnosis of nevus sebaceous, a biopsy of the cyst was done, which revealed a large cyst lined by columnar and myoepithelial cells in the dermis. The columnar cells at a few places showed “decapitation secretion” giving the impression of apocrine hidrocystoma. Post-excision of the cyst, biopsy of the entire nevus was done and the histopathological diagnosis correlated with the clinical diagnosis of nevus sebaceous. Apocrine hidrocystoma developing from a sebaceous nevus over the scalp is a rarity with only three other cases of it arising on the scalp being reported and none of them developed from a sebaceous nevus.

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Psoriasis is a common, chronic, disfiguring, inflammatory, and proliferative condition of the skin. It manifests with varying degrees of severity and can be treated with various immune modulators. This is a case report of a 57-year-old male patient of psoriasis on long-term oral methotrexate, who developed methotrexate toxicity when given an injection of methotrexate for unstable psoriasis. After recovery, the patient was started on cyclosporine 100 mg twice a day. After a week, he developed thrombocytosis, which reverted a week after cyclosporine was stopped. The patient is currently being managed with acitretin. The aim of this case report is to emphasize the various unpredictable adverse reactions encountered during treatment of psoriasis, especially when a combination or sequential treatment is used. There is a need for caution, as late sequelae of long-term administration of the systemic agents used in the treatment of psoriasis are still unknown.

density and few acneiform papules were observed over the patch [ Figure 1]. Histopathological examination of biopsy specimen showed hyperkeratosis, acanthosis, and heavy pigmentation of basal keratinocytes with melanophages in the upper dermis [ Figure 2]. Bone survey of ipsilateral lower limb with X-ray and computed tomography scan showed no abnormality. ABSTRACTBecker's nevus is an acquired and persistent asymmetrical area of skin pigmentation sometimes showing evidence of increased androgen sensitivity which typically occurs, postpuberty. Though the usual site is described as shoulder, anterior chest, or scapular region, it can occur over other unusual sites as well. We report such a rarer presentation of Becker's nevus on leg in a young female.