Multiple Segmental Eccrine Spiradenoma with a Zosteriform Pattern: A Case Report and Literature Review

Abstract

Eccrine spiradenoma usually occurs as solitary tender nodules. However, it rarely occurs as multifocal localized tumors or has zosteriform distribution. We report the case of a 32-year-old woman with a 20-year history of itchy lesions on the left side of the back and forearm with a zosteriform distribution. Before disease onset, almost no patients have inducing factors, but our patient received an injection beforehand; however, whether this was coincidental or causative remains unknown. The lesions became very itchy after perspiration or eating spicy food, which has never been reported. A literature search revealed 22 cases of multiple segmental eccrine spiradenoma; we summarized the clinical characteristic in order to aid diagnosis and treatment selection.

Multiple eccrine spiradenoma in a young Greek patient: case report and review of the literature

“…Few clinical variants have been described like solitary ES which is generally accepted as the most common, multiple ES and giant vascular ES. Review of the literature demonstrates that multiple ES includes less than 2% of all cases and the majority of these tumors are distributed by linear or zosteriform pattern [4]. Pathways underlying the pathogenesis of the tumor are still being elucidated.…”

“…The potential role of hereditary factors was pointed out by some investigators who suggested autosomal and dominant inheritance but their observations are still not established [5]. Interestingly, trauma has been speculated as precipitating factor leading to the development of ES [6].…”

“…Radiotherapy or CO 2 laser are alternative choices which have shown satisfactory results. Intralesional infusion of botulinum toxin A and triamcinolone has been tested providing minimal improvement and its long term efficacy remains questionable [11,12]. It is widely accepted that future studies are needed and until then surgical excision remains the gold standard therapy.…”

Malignant transformation of a spiradenoma with blaschkoïd pattern

“…No similar cases were noticed in his family. Twenty‐three cases of segmental spiradenomas have been described in the literature, of which only three cases have a blaschko‐linear distribution of the lesions 3. Autosomal dominant transmission has been suggested but not confirmed.…”

An Unusual Nodule on the Auricle: Eccrine Spiradenoma

“…Multiple lesions have been reported to occur either in random fashion or in linear, blaschkoid, nevoid, and zosteriform patterns. 3 Brooke-Spiegler syndrome is a rare autosomal dominant condition, which should be suspected in patients with spiradenomas occurring simultaneously with other adnexal pathology such as cylindromas and trichoepitheliomas. 4 The diagnosis is based on typical histopathological features.…”