Papular Clear Cell Hyperplasia of the Eccrine Duct

Abstract

We report the case of a 77-year-old diabetic patient with asymptomatic papular eruption developed over a cutaneous scar after the resection of a squamous cell carcinoma. Histological examination revealed a clear cell proliferation involving the secretory portion of the eccrine glands. This entity has been previously named as papular clear cell hyperplasia of the eccrine duct. This clear cell change might be caused by glycogen deposition because of diabetes. We postulate that papular clear cell hyperplasia could be a precursor lesion of clear cell syringoma.

Adult‐onset papular hyperplasia of eccrine glands associated with clear cells: is it a new entity?

“…The pathogenesis of PCCHEG remains unknown, and the clear cell changes seem to be unrelated to diabetes [2-5, 9, 10]. As contradictory results of PAS staining for clear cells have been reported [2][3][4][5], and the present results showed negative PAS and Alcian blue staining that mimicked previous results [8], it appears that the clear cell changes of eccrine glands might not result from accumulation of glycogen and mucopolysaccharide, at least not in all cases. The weak expression of α-1-antitrypsin in the present study supports the idea that normal apocrine sweat glands might secrete α-1-antitrypsin into sweat [8].…”

“…Papular clear cell hyperplasia of the eccrine duct (PCCHED), initially termed "eruptive clear cell hamartoma of sweat duct" [2], is an exceptionally rare disease, presenting as numerous, asymptomatic, skin-colored papules 1 to 3 mm in diameter [3]. It often involves the trunk, extremities, and scalp [2][3][4][5]. Four cases (all women) have been reported to date; their ages ranged from 37 to 77 years [2][3][4][5] women had diabetes [3,5].…”

“…Clear cell syringoma is a rare variant of syringoma characterized by clear cell nests and tubules, occasionally with tadpole morphology. The clear cells are positive with PAS staining, but become negative after exposure to diastase [4,5]. Eccrine nevus is an extremely rare cutaneous condition that often presents with localized solitary hyperpigmented or hypopigmented macules or papules, which are characterized histologically by an increase in size and/or number of normal eccrine sweat glands [1].…”

Im Erwachsenenalter erstmals aufgetretene papulöse Hyperplasie der ekkrinen Schweißdrüsen mit Klarzellen: Ist es eine neue Entität?

“…Rumpf, Gliedmaßen und Kopfhaut können betroffen sein [2][3][4][5] . Bisher waren weltweit vier Fälle beschrieben, alle bei Frauen im Alter zwischen 37 und 77 Jahren [2][3][4][5] , zwei der Frauen hatten einen Diabetes [ 3,5 ] . In der histologischen Untersuchung zeigten sich mehrere Schichten polygonaler Klarzellen mit kleinen, hyperchromen Zellkernen und großem, leer erscheinendem Zytoplasma.…”

“…Sie äußert sich mit zahlreichen asymptomatischen hautfarbenen Papeln von 1 bis 3 mm Durchmesser [ 3 ] . Rumpf, Gliedmaßen und Kopfhaut können betroffen sein [2][3][4][5] . Bisher waren weltweit vier Fälle beschrieben, alle bei Frauen im Alter zwischen 37 und 77 Jahren [2][3][4][5] , zwei der Frauen hatten einen Diabetes [ 3,5 ] .…”