Dermoscopy of Nodular Hidradenoma, a Great Masquerader: A Morphological Study of 28 Cases

Abstract

Background: Nodular hidradenoma is an uncommon, benign, adnexal neoplasm of apocrine origin which is a clinical simulator of other tumours. Objective: The aim of this study was to evaluate the morphological findings of a large series of nodular hidradenomas under dermoscopic observation. Methods: Dermoscopic examination of 28 cases of nodular hidradenomas was performed to evaluate specific dermoscopic criteria and patterns. Results: The most frequently occurring dermoscopic features were: (1) in 96.4% of cases, a homogeneous area that covered the lesion partially or totally, the colour of which was pinkish in 46.4% of cases, bluish in 28.6%, red-blue in 14.3%, and brownish in 10.7%; (2) white structures were found in 89.3% of cases; (3) in 82.1% of cases, vascular structures were also observed, especially arborising telangiectasias (39.3%) and polymorphous atypical vessels (28.6%). Conclusion: Nodular hidradenomas represent a dermoscopic pitfall, being difficult to differentiate clinically and dermoscopically from basal cell carcinomas and melanomas.

Sonographic Characteristics of Apocrine Nodular Hidradenoma of the Skin

“…Clinically, these tumors present as painless solitary erythematous or violaceous nodules on the head, trunk, limbs, or oral cavity, which rarely show malignant transformation . Their differential clinical diagnosis is wide and includes some variants of dermatofibromas, angiomatous tumors, ganglion cysts, and malignant tumors such as basal cell carcinomas (BCCs), squamous cell carcinomas, and melanomas, among others . Importantly, this benign tumor has been described as a dermatoscopic pitfall because it is a great simulator of other entities …”

Anogenital mammary-like gland adenoma: report of two cases and review of literature

“…6 Due to its variable and nonspecific clinical presentation it might be difficult to make a correct diagnosis of this tumor. 4 In our cases, the tumors were asymptomatic and diagnosis was finding of a physical examination, suggesting an underestimation of the prevalence of these tumors. Its differential diagnosis includes various adnexal tumors, epidermal cysts, cutaneous metastases, basal cell carcinoma and melanoma.…”

“…The vascular structures objective is arborizing telangiectasias, polymorphous atypical vessels. 4 For both patients, the same dermoscopic aspects were revealed. Histopathological examination revealed a partly solid or solid-cystic dermal lesion with anastomosing papillary structures and tubules as well as some glandular areas.…”

“…Some tumors may spontaneously drain serous or haemorrhagic material. 4 This neoplasm may be found on the labia minora (50%) labia majora (40%), fourchette (7%) and clitoris (3%). 5 Rarely, it can be seen over the head and neck, and over modified apocrine gland areas such as breast, external ear canal, and eyelid.…”

“…Its differential diagnosis includes various adnexal tumors, epidermal cysts, cutaneous metastases, basal cell carcinoma and melanoma. 4 This makes biopsy of all vulvar lesions necessary in order to establish a diagnosis and rule out malignancy. 5 The most common dermoscopic pattern of hidradenoma papilliferum is homogeneous area which occupies the whole lesion with vascular and white structures is the most common dermoscopic pattern.…”