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

Abstract

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.

A Case of Eccrine Poromatosis in a Patient with a History of Chemotherapy Due to Stomach Cancer

“…Particularly in terms of chemotherapy, a direct sweat duct cytotoxicity from a toxic chemotherapy metabolite has been suspect. About 11 eccrine poromatosis cases, which are related to the chemotherapy, were described in English literature ( Table 1 ) 1 3 4 5 6 7 8 9 10 11 .…”

“…Except one case with systemic lupus erythematosus patient 12 , the rest patients had underlying hematologic malignancies and multiple chemo regimens including cyclophosphamide, vincristine, and doxorubicin have been frequently reported. The time interval of poroma development has ranged from onset during chemotherapy treatment to decades following therapy 4 . Also, due to its long latency period between the end of chemotherapy and diagnosis, remodeling of the sweat gland apparatus or regeneration of damaged skin appendages has been suggested 3 .…”

Multiple Plantar Poromas in a Stem Cell Transplant Patient

“…Multiple poromas have been reported in patients with a history of lymphoproliferative neoplastic conditions treated with radiation therapy, chemotherapy, and stem cell transplantation [4][5][6][7][8][9][10][11][12]. Importantly, onset of multiple poromas involving acral and nonacral sites can vary from months to years after treatment cessation.…”

Eccrine poromatosis following chemotherapy and radiation therapy

“…Chemotherapy or radiation therapy may be the most likely etiology for eccrine poromatosis. That is, a history of chemotherapy and/or radiation therapy is often noted in eccrine poromatosis cases (Table 1), [2,3,[5][6][7][8][9][10][11][12][13][14][15][16][17]. Although it is common for patients to receive both chemotherapy and radiation therapy throughout the course of their neoplastic treatment, eccrine poromatosis most commonly occurs on nonirradiated skin in patients who received polychemotherapy [2].…”

“…Treatment of eccrine poromas is typically done by simple excision. Other successful treatment modalities have included electrosurgical desiccation, cryotherapy, and imiquimod [4,9]. Eccrine poromas can rarely transform into eccrine porocarcinomas.…”