Indian Journal of Dermatology
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CORRESPONDENCE
Year : 2022  |  Volume : 67  |  Issue : 5  |  Page : 592-593
Pigmented eccrine poroma: Report of a case with the use of dermoscopy


1 Department of Dermatology, Sheikh Khalifa Hospital, Faculty of Medicine, Mohamed VI University of Health Sciences, Casablanca, Morocco
2 Department of Anatomopathology, Sheikh Khalifa Hospital, Faculty of Medicine, Mohamed VI University of Health Sciences, Casablanca, Morocco

Date of Submission12-Jan-2021
Date of Acceptance01-Jan-2022
Date of Web Publication29-Dec-2022

Correspondence Address:
Kenza Oqbani
Department of Anatomopathology, Sheikh Khalifa Hospital, Faculty of Medicine, Mohamed VI University of Health Sciences, Casablanca
Morocco
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijd.ijd_1031_21

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How to cite this article:
Agharbi FZ, Oqbani K, Basri G, Faik M, Chiheb S. Pigmented eccrine poroma: Report of a case with the use of dermoscopy. Indian J Dermatol 2022;67:592-3

How to cite this URL:
Agharbi FZ, Oqbani K, Basri G, Faik M, Chiheb S. Pigmented eccrine poroma: Report of a case with the use of dermoscopy. Indian J Dermatol [serial online] 2022 [cited 2023 Feb 8];67:592-3. Available from: https://www.e-ijd.org/text.asp?2022/67/5/592/366089




Sir,

Eccrine poroma (EP) is a rare benign adnexal tumour derive from sweat glands. Due to their rarity, the pigmented variant is usually underdiagnosed and mistakenly confused with other pigmented tumours.[1] Even if the diagnosis of EP remains histopathological still, dermoscopy may assist in the correct diagnosis.[2],[3],[4],[5]


   Case Report Top


A 45-year-old patient consulted for asymptomatic pigmented nodule of the foot evolving for 1 year. Clinically, the lesion was a homogeneous pigmented nodule of 1 cm with regular and well-defined edges [Figure 1]. Dermoscopy showed asymmetry blue–green colour at the periphery and multiple green white ovoid nests, polymorphic vascular structures in the centre (glomerular, hairpin vessels, dotted vessels and linear irregular but nonarborescent vessels) [Figure 2]. Histology revealed a symmetric and well-circumscribed tumour proliferation replacing the epidermis and extending into the dermis in endophytic and anastomosing bands. Poroma cells were small and monomorphic without atypia or mitosis [Figure 3]. Melanin pigments were noted [Figure 3 Encart].
Figure 1: Pigmented nodule on the back of right foot

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Figure 2: Hstologic section: eccrine poroma-pigmented variant (H&E × 100 magnification); Encart: poroma cells with pigmented features

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Figure 3: Green fleches: asymmetry blue–green colour at the periphery, orange circles: multiple green white ovoid nests and blue circles: polymorphic vascular structures in the centre

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   Discussion Top


EP is a rare benign adnexal tumour derive from the epithelium of the intraepidermal portion of eccrine sweat ducts.[1] Its pathogenesis is unknown, but may be related to trauma, radiation or scars.[3] Clinically, the tumour appears as a single slow-growing, papule, plaque, or nodule, pink-to-red, with occasional ulceration. The most common location is the soles or lateral borders of the feet.[2],[3] Pigmented EP is rare; it corresponds to only 17% of cases and seems to be more frequent in the black race and on nonacral sites. Two hypotheses are posed regarding its presence originating the pigmentation: the first is that it comes from melanocytes present in cell primordia of eccrine ducts during the 14th week of gestation that were not eliminated during the maturity process; the other hypothesis is that it comes from epidermal melanocytes.[1] The nonacral localization of this form is explained by the fact that the melanocytes in the palmar and plantar regions presented reduced migration, proliferation and survival. This variant is usually underdiagnosed and mistaken for other pigmented tumours such as melanoma, seborrheic keratosis, pigmented basal cell carcinoma, nevus or histiocytofibroma. Kuo and Ohara were first reported the dermoscopic findings in pigmented EP, which mimicked features of basal cell carcinoma, such as blue–grey ovoid nests, blue–grey dots and arborizing teleangiectasias.[3] Afterwards, Nicolino mentioned that irregular linear vessels seen are less well defined and with less branching that clear differed from the arborizing vessels in basal cell carcinoma.[2],[3],[5] Dermoscopy of nonpigmented EP is characterized by a vascular pattern, which may be polymorphous. Glomerular, hairpin vessels and linear irregular vessels, surrounded by a white to pink halo, may be observed. Reddish–white globule-like structures are occasionally seen, mimicking the red lacunae typical of vascular lesions, such as hemangioma or pyogenic granuloma. Milky-red areas, commonly found in melanoma, may also be present.[2],[4],[5] Dermoscopy is not specific but remains a noninvasive technique that can guide the diagnosis of EP especially a pigmented variant which is often unknown.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Cárdenas ML, Díaz CJ, Rueda R. Pigmented eccrine poroma in abdominal region, a rare presentation. Colomb Méd (Cali) 2013;44:115-7.  Back to cited text no. 1
    
2.
dos Santos BS. Clinical and dermoscopic features of eccrine poroma. Indian J Dermatol Venereol Leprol 2015;81:308-9.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
de Almeida FC, de Morais Cavalcanti SM, Medeiros AC, Teixeira MA. Pigmented eccrine poroma: Report of an atypical case with the use of dermoscopy. An Bras Dermatol 2013;88:803-6.  Back to cited text no. 3
    
4.
Nishikawa Y, Kaneko T, Takiyoshi N, Aizu T, Nakajima K, Matsuzaki Y, et al. Dermoscopy of eccrine poroma with calcification. J Dermatol Case Rep 2009;3:38-40.  Back to cited text no. 4
    
5.
Avilés-Izquierdo JA, Velázquez-Tarjuelo D, Lecona-Echevarría M, Lázaro-Ochaita P. Dermoscopic features of eccrine poroma. Actas Dermosifiliogr 2009;100:133-6.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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