Dermoscopic Features of Eccrine Porocarcinoma Arising from Hidroacanthoma Simplex

Abstract

Eccrine porocarcinoma is a rare cutaneous neoplasm that mainly affects elderly people and grows slowly over a long period of time but often experiences an accelerated growth phase. Eccrine porocarcinoma may arise de novo or evolve from a pre-existing benign eccrine poroma. We reported a 86-year-old Japanese woman presenting with two reddish-colored pendulated lesions on a keratotic light brown plaque on the right thigh. Dermoscopic examination of the light-brown plaque demonstrated many whitish globular structures in a light-brown background. At the two reddish-colored pendulated lesions, polymorphous and prominent vessel proliferation was observed together with irregularly shaped whitish negative network. Immunohistochemical study demonstrated a positive CEA staining at ductal structures and atypical clear cells of reddish nodules. A diagnosis of eccrine porocarcinoma arising in a pigmented hidroacanthoma simplex was eventually established, and the dermoscopic features of eccrine porocarcinoma from hidroacanthoma simplex was described for the first time.

Porocarcinoma: A systematic review of literature with a single case report

“…Metastasis is reported to occur in 20% of patients while current review among 36 studies and 61 patients showed that metastasis occur in 26%. The most common affected organ to which EP metastise is lymph nodes (60%) followed by chest (13%), Table 3 shows the involved organs in literatures with their frequency of affection [1], [6], [10], [11], [14], [16], [22], [24], [25], [28], [31], [33], [34]. Our case showed metastasis to lung, cervical lymph nodes and brain.…”

“…[10] Among reported cases, 8th decade of life is the ideal age of affection followed by 7th decade (Table 1). [1], [3], [6], [10], [11], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34] EP does not have predilection for specific part of the body. [24] Arslan et al stated that it tends to involve most frequently in the extremities especially lower limbs, followed by trunk and head while current literature review showed that EP occurs most commonly at the lower limbs (35%) followed by head(24%) and upper limbs (14%) (Table 2).…”

“…[24] Arslan et al stated that it tends to involve most frequently in the extremities especially lower limbs, followed by trunk and head while current literature review showed that EP occurs most commonly at the lower limbs (35%) followed by head(24%) and upper limbs (14%) (Table 2). [2], [6], [7], [10], [11], [12], [14], [15], [16], [19], [20], [21], [23], [25], [27], [29], [30], [33], [34], [35] However, the occurrence of EP is not correlated with the areas with highest concentration of hair (palmoplantar region) [18]. The current patient complained from EP of the posteromedial aspect of the left forearm.…”

“…[2], [3], [13], [11], [16], [17], [19], [23], [25], [27], [28], [31], [32] EP occurs as a single mass or nodule in 72% of the cases, ulceration (26%), and as a discharging sinus in 2% of cases. [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36] Although the pre-invasive markers and the pathogenesis of EP are not clear, according to some papers, risk factors include exposure of the affected area to trauma, burning, or radiotherapy, immunosuppressive drugs especially after organ transplantation, prolonged exposure to ultraviolet light and AIDS. [10] The gross examination is an important part of the assessment.…”

Dermoscopy Findings of Hidroacanthoma Simplex

“…In contrast to seborrheic keratosis, it is possible for eccrine porocarcinoma to develop from HAS [4]. Notably, HAS is sometimes misdiagnosed and treated by cryosurgery as seborrheic keratosis, which could trigger the development of porocarcinoma in the future.…”