Abstract

A young male patient presented with multiple swellings on his chest and the nape of his neck. Physical examination revealed multiple small papulonodular swellings measuring 0.5 × 0.5 cm to 2 × 2 cm, that were soft without discharge with no surrounding skin changes or induration. Skin biopsy samples were diagnosed as benign adnexal neoplasm consistent with eccrine spiradenoma, trichoepithelioma, and cylindroma, i.e., Brooke–Spiegler syndrome. Having confirmed this to be a case of eccrine spiradenoma, surgical excision was performed and the raw area was covered with a split thickness skin graft taken from the right thigh and sutured over the raw area. The sternal lesion was circumferentially excised and the wound was primarily closed by Z-plasty. Surgical excision is considered the gold standard for the treatment of these cases, with low rates of recurrence. Around 50 such cases have been reported in the literature to date. Although eccrine spiradenomas are usually solitary and small, the findings in our case underscore the fact that a variety of presentations are possible. With strict clinical suspicion and histological criteria, the correct diagnosis can be achieved, especially when combined with pertinent clinical information and laboratory studies.Level of Evidence: Level V, therapeutic study.

Highlights

  • Eccrine spiradenoma is an adnexal neoplasm that continues to be designated as a tumor with eccrine differentiation, it is currently considered an apocrine process

  • The exact etiology of these lesions is unknown, spiradenomas appear to be caused by a defective tumor suppressor gene; in Brooke– Spiegler syndrome (BSS), there is usually a defect in the CYLDI gene located on chromosome 16 at position 12.1 [4]

  • Eccrine spiradenoma is a benign adnexal tumor that appears as a small and bluish nodule that is typically tender on palpation

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Summary

Introduction

Eccrine spiradenoma is an adnexal neoplasm that continues to be designated as a tumor with eccrine differentiation, it is currently considered an apocrine process. These multiple, potentially painful spiradenomas were reported for the first time by Kerstein et al [1]. Eccrine spiradenomas are usually benign and mostly occur in patients aged 15–35 years [2]. About 15 cases of linear/zosteriform/nevoid/blaschkoid multiple spiradenomas have been reported [3, 4].

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