0
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Dermoscopy of eccrine angiomatous hamartoma: The spitzoid pattern

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Clinical presentation A 5-year old girl presented with an erythematous, asymptomatic nodule of the left knee, which appeared 1 year before (Fig 1). Fig 1 Clinical examination found an erythematous dome-shaped nodule of the left knee. Dermoscopic appearance Dermoscopic examination found a spitzoid pattern, with brown globules, a background of erythema, and a pseudo-reticular depigmentation around the globules (Fig 2). The lesion was excised to rule out a spitzoid melanoma. Fig 2 Dermoscopy shows a spitzoid pattern, with light to dark-brown globules, a background of milky-red erythema, and a pseudo-reticular depigmentation (inversed network) around the globules. Histologic diagnosis Histologic examination found in the reticular dermis an increased number of eccrine glands and terminal hair follicles admixed with irregular, dilated blood structures and fat lobules (Fig 3). Pathologic features were consistent with the diagnosis of eccrine angiomatous hamartoma (EAH). Key message EAH is a rare variety of hamartoma. EAH presents at birth or early childhood as a nonspecific red, brown, or yellow nodule or plaque. When symptomatic, EAH may be associated with hyperhidrosis or pain. 1 The diagnosis is established by histopathology. Recently, the first dermoscopic description of EAH was reported as the popcorn pattern, consisting of multiple yellow, confluent nodules in a popcorn shape, over a background of erythema and linear and arborizing blood vessels. 2 Here we report a typical case of EAH, with a spitzoid dermoscopic pattern. The presence of brown globules in dermoscopy is usually indicative of a melanocytic lesion, but in this case it is possible that the globules reflected the numerous dilated eccrine glands. The dermoscopic aspect of EAH is heterogeneous and can be misleading. More cases are needed to describe the dermoscopic landscape of EAH. Fig 3 The sections show increased numbers of eccrine glands and terminal hair follicles associated with abnormally dilated vessels (Hematoxylin-eosin saffron stain; original magnification per scale bar).

          Related collections

          Most cited references 2

          • Record: found
          • Abstract: found
          • Article: found

          Eccrine Angiomatous Hamartoma: A Clinicopathological Study of 26 Cases

          Background: Eccrine angiomatous hamartoma (EAH) is a rare benign cutaneous tumor characterized by the proliferation of eccrine glands and capillaries. Objective: The aim of this study was to summarize the clinicopathological characteristics of EAH. Methods: A retrospective chart review was performed on all patients diagnosed with EAH from 1977 to 2012 in the Union Hospital, Wuhan, P.R. China, and the clinicopathological features were compared with the cases reported in the literature. Results: A total of 26 patients with EAH were identified. The male:female ratio was 1.2:1. EAH most commonly presents as a solitary (80.8%) plaque (50.0%) on the lower extremities (61.5%). Most patients presented with hyperhidrosis localizing to the lesion. Although most patients did not have major pain or anatomic deformity, one patient had severe pain as well as difficulty walking and moving, necessitating leg amputation. The histopathological findings showed typical features of EAH. Conclusion: EAH is a rare but characteristically benign skin hamartomatous condition. In rare occasions it can be associated with severe structural and functional impairment.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Dermoscopy of eccrine angiomatous hamartoma: The popcorn pattern

            Clinical presentation A 21-year-old woman presented with a congenital red-yellow, velvety plaque on the right side of the neck (Fig 1). She complained of mild pruritus and excessive sweating on that area. Fig 1 Clinical examination found a red-yellowish, velvety plaque with verrucous surface on the right side of the neck. Dermoscopic appearance Dermoscopic examination found multiple yellow, confluent nodules in a popcorn shape, over a background of erythema and linear and arborizing blood vessels (Fig 2). Fig 2 Dermoscopy shows a popcorn pattern of linear yellowish nodules over a background of erythema and linear and arborizing blood vessels. Histologic diagnosis Histopathology found the hamartomatous presence of eccrine gland lobules, accompanied by dilated vascular lumina (Fig 3). A diagnosis of eccrine angiomatous hamartoma (EAH) was made, and treatment with 595-nm pulsed-dye laser was started. Key message EAH is a rare benign malformation characterized by the proliferation of eccrine sweat glands and dilated capillaries. It has no gender predilection and presents at birth or early childhood as a red, violaceous, brown, yellow, or skin-colored nodule or plaque. Associated signs and symptoms include mild pain, hypertrichosis, and sweating. 1 Etiology is unclear, although a defective interaction between the epithelium and mesenchyme resulting in abnormal proliferation of adnexal and vascular structures has been suggested.1, 2 Histopathology results show a well-demarcated lesion in the middle or reticular dermis, with proliferation of normal or enlarged eccrine sweat glands and vascular structures. 1 Treatment options include surgical excision, botulinum toxin for hyperhidrosis, pulsed-dye and neodymium-doped yttrium aluminium garnet lasers. 2 EAH is a heterogeneous entity; however, most of the published cases report similar clinical and histopathologic findings. 1 To the best of our knowledge, this case represents the first dermoscopic description of EAH, and we consider that this pattern may be useful for its diagnosis. However, this is an isolated case, and more cases should be reported to assess the specificity of this pattern. Fig 3 The sections show in a low-power view the hamartomatous presence of 5 to 6 lobules of eccrine glands that are accompanied by some dilated vascular lumina. (Original magnifications: A, ×4; B, ×10; C, ×20.)
              Bookmark

              Author and article information

              Contributors
              Journal
              JAAD Case Rep
              JAAD Case Rep
              JAAD Case Reports
              Elsevier
              2352-5126
              18 September 2018
              September 2018
              18 September 2018
              : 4
              : 8
              : 835-836
              Affiliations
              [a ]Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Service de Dermatologie, Nice, France
              [b ]11 Rue Chateauneuf, Nice, France
              [c ]Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, LPCE, Nice, France
              Author notes
              []Correspondence to: Philippe Bahadoran, MD, PhD, Department of Dermatology, Archet Hospital, 06202 Nice cedex 3. bahadoran.p@ 123456chu-nice.fr
              Article
              S2352-5126(18)30186-3
              10.1016/j.jdcr.2018.06.026
              6143715
              © 2018 by the American Academy of Dermatology, Inc.

              This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

              Categories
              Dermoscopy Cases of the Month

              Comments

              Comment on this article