Congenital eccrine angiomatous hamartoma: Expanding the morphologic presentation and a review of the literature

Abstract

Eccrine angiomatous hamartoma (EAH) is a rare benign vascular hamartoma characterized histologically by an increased size and number of mature eccrine glands associated with multiple foci of dilated capillaries in the dermis and subcutis. EAH typically presents in children as discrete, solitary nodules, or plaques most commonly located on the extremities. Some cases of EAH have an agminated distribution involving classic locations, or present as solitary lesions in less common locations such as the face, scalp, or trunk. We report the case of congenital EAH in a child with atypical morphological features and pattern of distribution further expanding on the range of presentations classically described.

Atypical presentation of pediatric antiphospholipid syndrome

“…EAHs are rare, benign, acquired, or congenital neoplasms of eccrine and angiomatous structures, often within the middle or deep dermis, that usually present on the distal extremities with varied clinical features, including pain and hyperhidrosis. 8 , 9 Herein we report a case of APS presenting as pain within a foot lesion, with changes consistent with EAH on pathology.…”

“…EAHs typically arise as a solitary red-blue plaque on a distal extremity and are often diagnosed after presenting with pain or hyperhidrosis. 8 , 9 The associated pain within the lesion, which has been attributed to the effects of temperature fluctuations and hormones on the vascular and eccrine tissue as well as fluid retention, 9 has been reported to resolve with expectant management, excision, or laser therapy. 10 These neoplasms, especially visually occult and asymptomatic variants, can be present for many years prior to symptom onset, as exemplified in this case.…”

A two‐year‐old girl with an erythematous‐bluish tumor on a shoulder

“…Surgical excision is the unique, definitive treatment. Other possible options, such as laser treatment, intralesional sclerosants or botulinum toxin, have shown variable outcomes [3,7].…”

Ein zweijähriges Mädchen mit bläulich‐erythematösem Tumor an der Schulter

“…Die chirurgische Exzision ist die einzige endgültige Behandlung. Andere Optionen wie Laserbehandlung, intraläsionale Sklerosierung oder Botulinumtoxin führten zu unterschiedlichen Ergebnissen [3,7].…”

“…Es wird vermutet, dass es sich um eine Störung der Interaktion zwischen differenzierendem Epithel und dem darunter liegenden Mesenchym handelt, die zu abnormer Proliferation von Adnex-und Gefäßstrukturen führt. Es wurde auch postuliert, dass dies auf wiederholte Mikrotraumen zurückzuführen sein könnte, insbesondere bei Erwachsenen [7]. Man nimmt an, dass die Schmerzen durch kleine Nerven verursacht werden, die die Läsionen infiltrieren [1].…”