Hard asymptomatic papules and nodules on the scalp

Abstract

An 84-year-old woman was referred to our clinic because of multiple, hard asymptomatic nodules on her scalp, which were evaluated four months previously. The patient had no drug allergies. The only medical history of interest was a case of actinic keratosis located on the scalp, which was treated with photodynamic therapy eight months prior to our consultation. She did not report local symptoms during the appearance of the lesions, and had not pre-treated the current injuries. Clinical findings Clinical examination showed multiple yellowish-white, non-coalescent, asymptomatic papules and nodules (Figure 1a). Palpation revealed a cobblestone appearance, without infiltration of deep planes. Dermatoscopy showed well-demarcated, yellowish, keratotic-like structures (Figure 1b) and shiny white oval structures (Figure 1c, arrow). No vascular component was seen. The cutaneous ultrasound showed oval structures of hyperechoic content Hard asymptomatic papules and nodules on the scalp Case for Diagnosis Figure 1 Multiple solid consistency papules and nodules on the scalp (a). Keratotic yellow structures without vascular structures (Dermlite 4®) (b). Well-defined whitish structures (arrow) without vascular structures (Dermlite 4®) (c).