Syringocystadenoma papilliferum (SCAP) is an uncommon, benign adnexal neoplasm that occurs de novo or in an organoid nevus. It usually presents as a skin-coloured to pink, solitary, smooth, hairless plaque, verruca or nodule frequently on the scalp and forehead. SCAP may be present at unusual sites including the arm, forearm, trunk and chest. Diagnosing SCAP arising on uncommon sites is difficult owing to its varied presentation. Mostly, they are wrongly diagnosed clinically and found to be SCAP only on histopathology. We present this study of cases of SCAP with unusual location and varied presentations, which were clinically misdiagnosed. The five cases included in this study were patients attending the dermatology outpatient department in a tertiary care centre in North India. The clinical presentation and the involved sites were noted by the dermatologist, and a clinical diagnosis was made. Biopsy of the lesions was sent for histopathological examination. There are five patients in the series – four are male and one female, with age ranging from 28 to 48 years. Locations included the forearm, arm, anterior chest wall and lateral abdominal wall. The lesions clinically appeared as warty papule or nodules and one lesion appeared within a plaque, with the average duration being 5.3 years. In all five patients, the lesions were clinically suspected to be either tuberculosis verruca cutis or nodular basal cell carcinoma or dermatofibroma sarcoma protuberans (DFSP) or verruca or fibroma or pyogenic granuloma. A confirmatory diagnosis of SCAP was made for all the patients on histopathology. We are presenting five cases which were misdiagnosed clinically due to the unusual location and varied presentation to emphasise the importance of histopathology in diagnosing SCAP arising de novo , which was clinically misdiagnosed. Also, we present this case series to alert the clinicians about the likelihood of SCAP on unusual locations with varied clinical presentation.

Objective: Chronic obstructive pulmonary disease (COPD) is the vital cause of morbidity and mortality in Western world, though it has become an increasing cause of mortality in India also in the past decade. Another concern is that COPD patients use medications that stimulate the cardiovascular system, including anticholinergic agents and sympathomimetic medications to study the prevalence of cardiovascular comorbidities in patients with COPD. Methods: It was a prospective observational study, which was conducted on inpatient subjects diagnosed to have COPD based on GOLD guidelines 2020, for a period of 1 year in tertiary care hospital. Results: The most of the patients were in 60–80 year age group (70%) and majority was males (87%). All the males (n=87) were smokers (62 ex-smokers and 25 present smokers) while all females (n=13) were non-smokers. The mean BMI for patients with CVD was 25.85±4.19 kg/m2 while for patients without CVD, mean BMI was 27.46±3.98 kg/m2. About 63.2% of the males (n=87) had some cardiovascular comorbidity as compared to 38.5% of females (n=13). The prevalence of cardiovascular comorbidities in subjects with COPD was 60% in the present study. This was significantly higher in patients with COPD as compared to the reported prevalence value in the general population of comparable age group. The prevalence of associated cardiovascular abnormality in COPD patients with increased PCV (Packed cell volume), leukocytosis, and neutrophilia are 56.3%, 65%, and 60%, respectively. The most common cardiovascular comorbidity in subjects with COPD was ischemic heart disease (21%), followed by heart failure (20%), stroke (5%), arrhythmias (3%), and LVH (3%).