Reactive Eccrine Syringofibroadenoma Associated with Neuropathy, Venous Stasis, and Diabetic Foot Ulcer

Abstract

Eccrine syringofibroadenoma (ESFA) is an uncommon benign adnexal neoplasm which derives from cells of the acrosyringium of eccrine sweat glands. The clinical appearance is nonspecific but the histological features are typical. Five clinical subtypes of ESFA exist: (1) solitary ESFA; (2) multiple ESFA associated with ectodermal dysplasia; (3) multiple ESFA without cutaneous features; (4) unilateral linear ESFA (nevoid), and (5) reactive ESFA associated with inflammatory or neoplastic dermatoses. We report the case of a 42-year-old man with long-standing diabetes and neuropathy, presenting with a 4-year history of asymptomatic erythematous plaques on a background of brown hyperpigmentation on the left foot. The clinical presentation and histopathological findings are compatible with reactive ESFA.

Reactive Eccrine Syringofibroadenoma on the Heel, Clinically Mimicking Squamous Cell Carcinoma

“…Reactive ESFA is associated with tissue remodeling and has been found together with erosive palmoplantar lichen planus [3], bullous pemphigoid [5], burn scar [6], lepromatous leprosy [7], diabetes mellitus with polyneuropathy and chronic ulcers [8], nevus sebaceous, or squamous cell carcinoma [9]. In the present patient, both chronic stimulation and repetitive ulceration may have been associated with the development of reactive ESFA.…”

Recalcitrant erosive plaques on the palms and soles: A rare manifestation of eccrine syringofibroadenoma

“…ESFA may resolve spontaneously; however, alternative treatments for refractory ESFA have been reported with varying degrees of success, including radiotherapy, photodynamic therapy, 5-fluorouracil, and imiquimod. 9 , 10 …”

“…ESFA may resolve spontaneously; however, alternative treatments for refractory ESFA have been reported with varying degrees of success, including radiotherapy, photodynamic therapy, 5-fluorouracil, and imiquimod. 9,10 For our patient, after the diagnosis of ESFA was made, we continued halobetasol ointment 0.05% for 1 month with minor improvement. Because of the patient's concerns regarding the cost of the medication, we replaced halobetasol with triamcinolone ointment 0.1% twice daily, with home wound care 3 times a week using petrolatum gauze and fabric gauze bandages.…”

Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation

“…Less than 100 cases have been reported [ 228 ]. The age of onset varies, and the lesion typically presents between 16 and 80 years, although solitary lesions are seen most commonly in the seventh and eighth decades [ 235 ]. Sex predilection is unknown due to limited data.…”

“…That subtype may therefore be regarded as secondary, non-autonomous epidermal hyperplasia [ 240 ]. Other therapeutic options include cryotherapy and CO 2 laser therapy, photodynamic therapy, curettage, electrodesiccation, and radiotherapy, as well as topical and systemic retinoid acids, 5-fluorouracil and imiquimod, with variable patient outcomes [ 228 , 231 , 235 , 236 , 241 , 242 ].…”