Masquerading eyelid mass: An unusual case of eccrine poroma

Epidermal inclusion cyst of the breast: A case report.

Pathogenesis of Plantar Epidermal Cyst: Three-Dimensional Reconstruction Analysis

Dear Editor, Eccrine poroma stands as a benign adnexal neoplasm that originates from the acrosyringium. It typically emerges as solitary, flesh-colored, or erythematous papules, plaques, or nodules, primarily appearing in areas with sweat glands. As well as pigmented lesions, dermoscopy has proven to enhance the clinical diagnosis of numerous non-pigmented skin tumors, including eccrine poroma. Herein we present a case of eccrine poroma located on the dorsal aspect of the left foot, with characteristic dermoscopic features. A 60-year-old woman was admitted with an asymptomatic lesion on the dorsum of her left foot, which had manifested approximately four years before. Clinically, the lesion presented as a well-circumscribed, violaceous, 0.9x0.9 cm papule (Figure 1a). Dermoscopic examination revealed flower-like and leaf-like vascular patterns, white interlacing areas, glomerular vessels, and milky red globules (Figures 1c-d). The lesion was excised and histopathologic findings were consistent with eccrine poroma (Figure 1b). Eccrine poroma (EP) is an adnexal tumor originating in the intraepidermal part of the eccrine sweat gland duct. Dermoscopy and histopathology help to differentiate EP from pyogenic granuloma, seborrheic keratosis, verruca vulgaris, basal cell carcinoma, squamous cell carcinoma, and amelanotic melanoma. Well-defined dermoscopic features in EP are: White interlacing areas around vessels, milky-red globules, flower-like and leaf-like vascular patterns, glomerular vessels, hairpin vessels, yellow structureless areas, poorly visualized vessels, and well-circumscribed globular or lacuna-like structures separated by white to pink mesh bands [1-3]. Histologically, EP manifests as a well-contained tumor constituted of proliferative cuboidal or poroid cells, often extending from the basal epidermis into the dermal layer. Shave, electrosurgical destruction or simple excision may be the treatment of lesions, depending on the depth of the lesion. Kind Regards

Eccrine poroma (EP) is a benign adnexal neoplasm that can be pigmented in 17% of cases. Four histopathological variants of EP exist. Dermoscopically, EP can mimic many other skin neoplasms. To provide a dermoscopic-histopathological correlation of EP, classifying the clinical and dermoscopic features of EPs on the basis of their histopathological subtype, in an attempt to better characterize these entities. A single-center retrospective study was conducted. Clinical data were collected; patients were classified on the basis of the 4 histopathological variants of EPs. Dermoscopic images were reviewed. A dermoscopic-histopathological correlation was performed, and the results were compared with literature data. Twenty-six lesions were included, both pigmented and nonpigmented. Three of the 4 histopathological variants were identified. Different dermoscopic features were observed for each distinct histopathological subtype of EP. The lesions mimicked different types of other skin neoplasms, in particular: nonpigmented hidroacanthoma simplex resembled nonmelanoma skin cancer; pigmented hidroacanthoma simplex appeared like a seborrheic keratosis or a solar lentigo; EPs sensu stricto presented as pink nodules if nonpigmented and were similar to seborrheic keratosis if pigmented; dermal duct tumors appeared as pigmented nodular lesions. Distinct dermoscopic features appeared to be recurrent in each histopathological variant. Dermoscopy can provide important clues for the diagnosis of EP; the final diagnosis is allowed by histopathology. To achieve a correct diagnosis of EP, because of its clinical and dermoscopic variability, surgical excision is recommended.

Eccrine poroma is a benign adnexal tumour, which originates from the acrosyringium of eccrine sweat glands. Eccrine poroma is an uncommon neoplasm, the typical clinical presentation of which is a solitary soft sessile reddish papule protruding from a cup-shaped shallow depression. Many challenges remain in the diagnosis of eccrine poroma because it does not always present with classical features and may mimic any other cutaneous benign and malignant lesions. Eccrine poromas may occur on any skin surface with sweat glands; on the other hand, the most common sites of involvement include the palms and soles, which are rich in eccrine sweat glands. Here, we present a case of subungual eccrine poroma, which is an extremely rare presentation of poromas. We also highlight dermoscopic features of eccrine poroma and review the available literature on the subject.

Eccrine poroma (EP) is a benign adnexal tumor that is derived from acrosyringium, the intraepidermal eccrine duct of sweat glands. The standard treatment for eccrine poroma is complete excision. However, this case report highlights cryotherapy as one of the modalities in treating eccrine poroma. We present a case of a 33-year-old male patient who was a known case of generalized vitiligo since he was nine years old. During our skin checkup before starting him on phototherapy, we found a mass over the palmar aspect of the middle finger of the right hand that started to appear five years ago. The mass gradually increased in size, was painless, has no discharge, and was not associated with a history of trauma or infection. The review of systems was unremarkable. Skin examination revealed an asymptomatic, 2.0 × 1.5 cm-sized, solitary, collarette-encircled, dome-shaped, flesh-colored, non-pigmented, deep-red nodule protrusion from the palmar aspect of the middle finger of the right hand. Poroma was considered as the diagnosis, and a punch skin biopsy was performed to confirm the diagnosis and to roll out pyogenic granuloma, amelanotic melanoma, and porocarcinoma as differential diagnoses. A 3 mm punch skin biopsy was performed under local anesthesia and was found to be histologically consistent with eccrine poroma. Hence, cryosurgery was chosen based on histological favorable features. We used cryospray in a single session of 15 seconds in three applications, with five-second intervals in between (skin frosting recovery). Furthermore, the lesion was completely curative with a single session of cryotherapy. The patient followed up for one year without evidence of recurrence.

Eccrine poroma (EP) is a benign adnexal tumor. Establishing a definitive diagnosis based on clinical and dermoscopic findings can be challenging. The aim of this study was to perform a comprehensive analysis of the dermoscopic features of pigmented, hypopigmented, and nonpigmented variants of EP and to compare these dermoscopic features in patients with dark and light Fitzpatrick skin phototypes. A total of 26 cases of histopathologically confirmed EP were included. Each case was categorized as pigmented, hypopigmented, or nonpigmented based on the melanin content within the lesion. Patients were classified according to their Fitzpatrick skin phototypes. Dermoscopic images were subjected to revised pattern analysis, and the results were compared with the existing literature. Regarding Fitzpatrick skin phototype, four (15.4%), 11 (42.3%), six (23.1%), and five (19.2%) patients had Fitzpatrick skin phototypes II, III, IV, and V, respectively. Of the cases, 17 (65.4%) were classified as nonpigmented, three (11.5%) as hypopigmented, and six (23.1%) as pigmented EP. All pigmented EP cases occurred in patients with dark skin and were located on non-acral sites. Polymorphic vascular pattern, branched vessels with rounded endings, linear-irregular vessels, interlacing white areas around vessels, and collarettes were more frequently observed in patients with light skin. In contrast, clod vessels, coiled vessels, white lines, ulceration, fiber sign, scales, and structureless areas were more common in patients with dark skin. This study underscores the significant dermoscopic diversity observed in EP, revealing distinct patterns based on pigmentation and Fitzpatrick skin phototypes.

An eccrine poroma is a benign neoplasm that originates from the intraepidermal ductal portion of the eccrine sweat duct. Although eccrine poromas are most commonly found on the sole or side of the foot, eccrine poromas have been observed on other areas of the skin, such as the scalp, neck, and chest. We report an interesting case of an eccrine poroma, which presented as a 1×1 cm protruding dome-shaped, skin-colored-to-black nodule on the right postauricular area. The patient denied a previous history of trauma to this area. The histopathologic diagnosis was consistent with an eccrine poroma. There has been no local recurrence 5 months after complete excision.

Quiste de inclusión epidérmica gigante de localización mamaria

Eccrine poroma is a benign adnexal tumor that originates from the uppermost portion of the intraepidermal eccrine duct. It usually presents as a solitary tumor. Histopathology shows a monomorphic proliferation of cuboidal cells, which radially extend from the basal layer to the dermis. Here, we present a rare multilesional eruption of eccrine poroma after chemotherapy and bone marrow stem cell transplantation for acute promyelocytic leukemia along with a description of clinical, pathological, and dermoscopic findings.

CASE REPORT An 80-year-old male visited our outpatient clinic with the presence of a progressively enlarging eczematous plaque over the right neck close to the post-auricular area for 2 years. The skin lesion was unresponsive to cryotherapy and topical steroids. At this presentation, the physical examination revealed a ten dollar coin-sized, polygonal, salmonred firm plaque with erosions and crusts, accompanied with a pinkish small nodule which was located in the center of the plaque (Fig. 1). Under the suspicion of chronic eczema or deep fungal infection, we performed a skin biopsy. The pathology revealed a malignant neoplasm of skin composed of pleomorphic basaloid and squamoid cells with frequent mitoses and apoptosis. The tumor was epidermal-based with dermal extension and anastomosing tumor cords showing multiple connections to the epidermis (Fig. 2A, 2B). Ductal differentiation is seen and can be accentuated under both epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA) stains (Fig. 2C, 2E). Taken together, an eccrine porocarcinoma (EP) was diagnosed. The patient received a wide local excision thereafter. The pathology reported eccrine porocarcinoma with bowenoid features. Focal en mass necrosis (Fig. 2D), focally infi ltrative border, ductal differentiation, and intracytoplasmic lumina. Squamous differentiation was also noted. There were frequent mitoses (>30 per 10 HPFs) and perineural invasion, without evidence of lymphovascular invasion. The mainly pushing advancing behavior and focal dyskeratosis were characteristic of bowenoid pattern. The post-operative course was smooth and there was neither recurrence nor evidence of metastasis in eleven months of follow-up to date. EP was first described by Mishima an Morioka in 1969 as a malignant counterpart of eccrine poroma, with both neoplasms putatively arising from the intraepidermal portion of the eccrine sweat duct or acrosyringium. Since then about 200 cases of EP have been reported in the literature, but there have been few large series. The tumor either arises spontaneously or develops in a longstanding eccrine poroma. Although often red and papular, the lesion can be flesh-colored or appear as a plaque, polypoid or verrucous lesion or as an ulcer, which sometimes bleed with minor trauma. Unlike benign eccrine poroma, which is often found on the palms and soles, most eccrine porocarcinomas arise on the lower extremity with the trunk and head also representing common sites, and the least common being on the palm and neck. The histologic diagnosis of EP was predicated on the basis of an irregular tumor at least partly formed of characteristic poromatous basaloid epithelial cells displaying ductal differentiation, and significant cytologic atypia. Most of them contained mature well-formed eccrine ducts having an eosino-

Eccrine poroma and porocarcinoma on the same unusual location: report on two cases.

Introduction: Eccrine Poroma (EP) is a rare benign adnexal neoplasm originating from the intra-epidermal portion of the sweat gland duct. The breast is an extremely rare site for this tumor, with only one reported case in the literature. This report highlights its unusual clinical presentation, surgical approach and follow-up. Objective: Aim of this study is to present a case report of EP involving the breast and to review the existing literature on this rare cutaneous neoplasm in atypical anatomical locations. Materials and methods: A 66-year-old woman presented with a slow-growing cutaneous lesion on her left breast. Clinical examination revealed a pink bluish dome-shaped nodule. Imaging studies was suggestive of breast tumor with low suspicion of malignancy. Histopathological examination and immunohistochemical staining confirm the diagnostic of eccrine poroma. Surgical excision with clear margins was performed and no recurrence or malignant transformation was observed. Results: Eccrine poroma of the breast is a rare benign tumor that can present diagnostic challenges, particularly when they mimic malignant lesions clinically and radiologically. Histopathological examination remains the gold standard for diagnosis, immunohistochemical staining can further support the diagnosis. Treatment typically involves surgical excision with clear margins and prognosis is excellent, with low rates of recurrence or malignant transformation. Conclusion: EP is known as the great imitator due to its clinical and dermoscopic diversity. Despite its rare occurrence, EP should be considered in the differential diagnosis of a slowly growing breast mass with typical clinical features. Keywords Eccrine poroma; Breast; Sweat gland neoplasms; Surgical excision; Porocarcinoma; Case report

Rationale:Eccrine poroma, a benign cutaneous neoplasm originating from the intraepidermal portion of the eccrine sweat duct, is relatively common in clinical practice. Nevertheless, the 1 presenting as spindle-shaped plaque is extremely rare and easily misdiagnosed as seborrheic keratosis or other dermatoses. Thus, the current study demonstrates a case of eccrine poroma with unique clinical manifestation.Patients concerns:A 47-year-old man presented with a spindle-shaped plaque on his left sole for 6 years.Diagnoses:Based on the clinical and histopathological manifestations, diagnosis of eccrine poroma was established.Interventions:Surgical excision under local anesthesia was performed.Outcomes:No recurrence or malignant transformation occurred within 6-month follow-up.Lessons:Eccrine poroma typically presents as a dome-shaped nodule on palm or sole. But this case reminded us the lesion presenting as a spindle-shaped plaque on sole can not rule out the possibility of eccrine poroma.

Epidermal inclusion cyst is one of the most common subcutaneous tumors, and its size normally varies from 1 to 5 cm in diameter. Only few giant epidermal inclusion cysts have been reported in the literature, and giant epidermal cyst of the face has never been reported. An 83-year-old woman visited our hospital for a huge mass on the right side of her face extending to the temporal area, creating deformity of her right ear. The mass was 15 × 15 × 8 cm(3) with soft, cystic nature. It has developed since 20 years ago with no known etiology. Computed tomography scan was obtained for preoperative evaluation, which showed a 15 × 15 × 7-cm(3) huge, lobulated, and septated mass with no underlying bone or brain involvement. We performed complete excision sand biopsy. On histologic examination, the final diagnosis of epidermal inclusion cyst was made. Keratotic material was within the cyst, and the cystic wall was composed of lamellate keratin. Follow-up period was 10 months, and no signs of recurrence were seen. The patient was satisfied with the improvement of her facial appearance. We have observed a case of giant epidermal inclusion cyst of the face, which has never been reported, and present this case with a brief review of literature.