In vivo Confocal Imaging of Pigmented Eccrine Poroma

Abstract

Background: Near-infrared reflectance confocal microscopy (CM) imaging is a noninvasive technique that can be utilized to evaluate histologic features of cutaneous lesions in vivo. Objective: A case of pigmented eccrine poroma was examined with CM. Methods: Confocal images were taken to define the features of the lesion and correlated with transverse hematoxylin-eosin (HE)-stained sections. Results: In CM imaging, a well-demarcated homogeneous nest consisting of small uniform cells was seen. The nest contained nonrefractile dark spaces that may represent cuticuli. Many dendritic melanocytes containing melanin were intermingled with the tumor cells, and numerous melanophages were present in the upper dermis. A marked prominence of surrounding vessels was also demonstrated. Conclusions: CM could well demonstrate the features of a pigmented eccrine poroma, as correlated with transverse HE-stained sections. However, high reflectance signals from melanin had to be carefully considered before a definitive diagnosis could be made.

Dermoscopy of Eccrine Poroma

“…Additionally, blue-white color might also be found, as the only feature, in nodular melanoma or pigmented squamous cell carcinoma [8, 9], especially when seen in a rapidly growing or changing lesion, as it was the case in our patient. In contrast to the former dermoscopic reports, Tachihara et al [12] examined a case of pigmented EP by near-infrared reflectance confocal microscopy imaging and correlated their findings with the underlying histopathologic features. Shortly, this new noninvasive, albeit still experimental, technique permits the visualization of single cells of cutaneous lesions located in the epidermis down to the papillary dermis and represents a promising tool for the evaluation of histopathologic features of skin lesions in vivo.…”

Noninvasive Imaging of Skin Tumors

“…26,27 Because in vivo CSLM provides high-resolution and instantaneous imaging of cellular and architectural details in human skin, it has been explored for use in the diagnosis of a variety of cutaneous diseases. [28][29][30][31][32][33] As pigment melanin is a strong source of contrast in CSLM, the employment of this technique for differentiation between benign and malignant melanocytic lesions seems particularly interesting. Melanocytes are usually round to oval, but fusiform or dendritic shapes are also observable.…”

Reflectance Confocal Microscopy for the Evaluation of Solitary Red Nodules

“…Histopathology confirmed a nonmelanocytic skin tumor as the lesion was diagnosed as eccrine poroma. Notably, since the RCM features of nonpigmented eccrine poroma have not been previously described, RCM could not result in a more accurate diagnosis [26]. …”