Eccrine poromas in a patient with mycosis fungoides treated with electron beam therapy

[Management of malignant adnexal neoplasms of the skin]

Malignant adnexal neoplasms of the skin are a heterogeneous group of rare malignancies with eccrine, apocrine, sebaceous and follicular differentiation. Essential clinical practice recommendations for the overall management of these cancers are presented. Moreover, specific evidence-based findings according to diagnosis, therapy and follow-up of porocarcinoma, sebaceous carcinoma and microcystic adnexcarcinoma will be explained.

Multiple Plantar Poromas in a Stem Cell Transplant Patient

Poromatosis, or the formation of multiple eccrine poromas, is associated with chronic immunosuppression, lymphoproliferative neoplasms, and stem cell transplantation, though the etiology and clinical significance remain poorly understood. Eccrine poromas are asymptomatic, may appear years after treatment, and overlap morphologically with other diagnoses, particularly human papillomavirus-associated verrucae, to which immunosuppressed patients may be predisposed and commonly occur in similar sites. We report a 47-year-old female on chronic immunosuppression who developed multiple plantar eccrine poromas three years after achieving acute myeloid leukemia (AML) remission following treatment with chemotherapy, total body irradiation, and allogenic stem cell transplantation. We propose that early recognition, timely treatment, and regular follow-up skin examinations are necessary in the setting of multiple poromas to reduce the risk of malignancy and avoid delays in diagnosis.

Eccrine Porocarcinoma: New Insights and a Systematic Review of the Literature

BACKGROUND

Eccrine porocarcinoma (EPC) is a rare cutaneous neoplasm with high potential for morbidity and mortality. Due to its rarity, there is a paucity of data profiling diagnosis, work-up, and management.

OBJECTIVE

To consolidate reported information on demographics, diagnostics, clinical behavior, treatment modalities, and patient outcomes in EPC to provide a reference tool to optimize diagnosis and management.

METHODS

A comprehensive PubMed search was performed from 1963 to November 2017 using PRISMA guidelines. This yielded 155 articles detailing 206 cases of porocarcinoma.

RESULTS

Eccrine porocarcinoma most often presents in elderly patients on the head and neck or lower limbs. Metastatic disease at presentation is not uncommon (22%). Primary tumor location is significantly correlated with presence of metastasis (p = .038). The most common treatment is excision followed by Mohs micrographic surgery (MMS), although the outcomes after MMS were superior to those after surgical excision.

CONCLUSION

This systematic review of individual patient data reveals that all patients should have a histological diagnosis with imaging considered for high-risk cases. Primary tumor location should also be considered in diagnostic and therapeutic decision-making. Although wide local excision (WLE) is currently the first-line treatment, MMS is becoming increasingly used, with evidence indicating improved outcomes as compared to those seen with WLE.

Multiple Eruptive Eccrine Poromas Associated with Chemotherapy and Autologous Bone Marrow Transplantation

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.

Eruptive poromatosis in a patient with breast cancer

Poromas are a group of benign growths of poroid differentiation derived from cells of the terminal sweat duct and connected to the epidermis, normally presenting as solitary papules, plaques or nodules. Rarely they can be eruptive in nature and as such are described as poromatosis. We report an unusual case of widespread poromatosis occurring in a woman with metastatic breast cancer who had recently completed chemo-radiotherapy.

Multiple apocrine poromas: a new case report

Apocrine poromas are rare and distinctive benign adnexal neoplasms featuring tumor cells differentiating toward folliculosebaceous-apocrine units. We report an extremely rare case with multiple apocrine poromas in a single patient. Fifteen tumors were distributed on the head, neck, forearm and axilla of a 74-year-old man. All tumors were mostly composed of poroid cells that surrounded variably sized duct spaces, some of which exhibited decapitation secretion. The poroid cells were continuous with infundibulum-like structures that contained aggregates of mature sebocytes. The patient had no family history of similar tumors and no history of immunosuppressive therapy. This is the first report of multiple apocrine poromas, suggesting that predisposing genetic factors might play a part in the development of the tumors.

Eccrine Poromatosis: Case Report, Review of the Literature, and Treatment

Eccrine poromas arise from the intraepidermal region of the eccrine sweat duct and most often occur as a benign solitary tumor. There are few reports of the occurrence of multiple lesions, defined as poromatosis, which may present in patients who have undergone radiotherapy and/or polychemotherapy. We report the case of a 43-year-old male with a history of mantle cell lymphoma who had undergone 6 cycles of polychemotherapy. He presented to the dermatology clinic for multiple painful lesions on his palms and soles. Several biopsies were performed consistent with eccrine poromas. The patient was successfully treated with a combination of excision, imiquimod cream, and cryosurgery. This case adds to the literature regarding the pathogenesis and treatment options of eccrine poromatosis. Herein, we report a case of eccrine poromatosis that developed after 6 cycles of chemotherapy.

Poroma: a review of eccrine, apocrine, and malignant forms

Poroma is a benign adnexal neoplasm of the terminal sweat gland duct. Although poromas have traditionally been thought to originate from the eccrine sweat gland, there have been cases of apocrine etiology as well. Eccrine and apocrine poromas typically present as erythematous or flesh-colored nodules on the palms and soles. As these features overlap with a multitude of differential diagnoses, it is imperative to have a firm understanding of the characteristics that make the diagnosis of poroma. In addition, the malignant counterpart to the poroma, the eccrine porocarcinoma, manifests in a similar nonspecific fashion. Case studies and literature reviews have contributed immensely to our present knowledge of poroma and porocarcinoma. Given the rarity of these neoplasms, however, there remains a relative paucity of information on atypical presentations and rates of malignant transformation. In this article, the epidemiology, clinical presentation, diagnosis, and management of poroma and porocarcinoma will be reviewed. This systematic approach may serve as a guide in navigating the diagnostic dilemma of these rare cutaneous lesions.

Eccrine poromatosis: case report and review of the literature

Eccrine poroma (EP) is a benign tumor of the eccrine duct. Multiple EPs are defined as eccrine poromatosis (EPS), an uncommon phenomenon. To date there are only eight reported cases of EPS. This review exemplifies the epidemiology, pathogenesis, differential diagnosis, and histology of EP, while reviewing the eight cases of EPS. Six of the eight cases of EPS had a history of immunosuppression from either radiation or chemotherapy. This paper will also emphasize the importance of excision to avoid possible malignancy. Here we present a 73-year-old gentleman with EPS who was also treated with radiation and chemotherapy prior to the onset of the lesions.

Multiple eccrine poromas in the paw of a dog

A 5-year-old, spayed female boxer dog presented to the referring veterinarian with a year-long history of swelling, ulceration and pain in the pawpad of the fourth digit of the right forelimb. Histologically, the pawpad was expanded by a mass composed of small polygonal cells forming broad bands and trabeculae within the lower epidermis that often infiltrated and replaced the overlying keratinocytes and that extended into the dermis. Lobules of eccrine glands within the deep dermis occasionally had one or more eccrine ducts that were lined by neoplastic ductal epithelial cells that formed papillary projections lined by one to two layers of neoplastic cells. Approximately 1 month after amputation of the fourth digit pad, several smaller nodular masses developed in multiple digital pads and the metacarpal pad of the same paw. All of the neoplasms were histologically identical to eccrine poroma (juxtaepidermal acrospiroma), a common benign neoplasm in humans that originates from the acrosyringium and upper dermal duct of eccrine glands. To the authors' knowledge this is the first report documenting an eccrine poroma in a dog.

Multiple eccrine poromas in the setting of total body irradiation and immunosuppression

Eccrine poromas are benign, adnexal tumors that most often occur as a solitary lesion on the palm or sole. The occurrence of multiple eccrine poromas is extremely rare. In this report, we describe the development of several eccrine poromas in an acral distribution in a 42-year-old man. Before the appearance of these tumors, the patient had received total body irradiation and allogeneic bone marrow transplantation for treatment of acute lymphocytic leukemia. As a complication of the bone marrow transplant, the patient developed chronic graft-versus-host disease, which was treated with immunosuppressive therapy. We discuss this patient and review the available literature regarding multiple eccrine poromas.

A rapidly growing eccrine poroma in a pregnant woman

A variety of tumors develop or exacerbate during pregnancy and it is well known that a noticeable increase of eccrine activity occurs in this period. Eccrine poroma is a benign neoplasm that originates from the eccrine sweat gland. The development of this tumor during pregnancy is extremely infrequent. We report a rare case of rapidly growing eccrine poroma in an unusual location (the nose) in a pregnant woman.