Reactive eccrine syringofibroadenoma arising in peristomal skin: An unusual presentation of a rare lesion

Mattoch, Ingerlisa W.; Pham, Ngoc Thi; Robbins, Jason B.; Bogomilsky, Jodie; Tandon, Meena; Köhler, Sabine

doi:10.1016/j.jaad.2007.08.032

Cited by 21 publications

(19 citation statements)

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“…The clinical presentation of ESFA is protean and non‐specific, ranging from isolated lesions to multiple papulonodular formations arranged in a widespread, clustered or linear distribution . The age of onset as well as anatomical location are equally variable, depending on the ESFA clinical subtype …”

Section: Discussionmentioning

confidence: 99%

“…ESFA is currently thought to represent a histopathological reaction pattern rather than a distinct biological entity; accordingly, ESFA subtypes should not be regarded as manifestations of a single disorder . Solitary ESFA appears to be a benign neoplasm, while a hamartomatous nature may be ascribed to multiple ESFA and unilateral linear ESFA .…”

Section: Discussionmentioning

confidence: 99%

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Reactive eccrine syringofibroadenomatosis secondary to primary cutaneous amyloidosis: a novel association

Saggini

Mully

2014

J Cutan Pathol

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We report the unprecedented case of reactive eccrine syringofibroadenoma (ESFA) secondary to primary cutaneous amyloidosis. A 62-year-old woman of Asian ethnicity presented with a pruritic rash on the back of long-standing duration. Physical examination revealed diffuse hyperpigmentation localized to the interscapular region; there were a multitude of hyperpigmented macules merged in a rippled pattern intermixed with scattered papules and cobblestone-like areas. A punch biopsy from a papule was taken. Histopathological examination revealed a network of epithelial strands and cords hanging from the epidermis and harboring foci of ductal differentiation. Eosinophilic collections of amorphous material were found between the epithelial strands, obscuring the superficial dermis. The microscopic picture was consistent with primary cutaneous amyloidosis associated with reactive ESFA. Results of histochemical and immunohistochemical staining confirmed the diagnosis. We speculate that pathogenetic mechanisms intrinsic to primary cutaneous amyloidosis, in addition to unknown genetic factors, resulted in clinical changes of lichen amyloidosus associated with an abnormal hyperplastic epithelial response with histopathological features of ESFA rather than the common epidermal change of acanthosis and hyperkeratosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reactive eccrine syringofibroadenomatosis secondary to primary cutaneous amyloidosis: a novel association

Saggini

Mully

2014

J Cutan Pathol

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“…The detection of HPV 16 may not be coincidental, as HPV DNA has been detected in typical NS 28 and in other cases of CPD. A few cases showed persistence of cutaneous lesions, 14,19 one of which was associated with HPV infection that involved the mucosa. In concert, these factors possibly amplified the epidermal susceptibility to HPV infection as evident by the finding of HPV-related histologic changes including verrucous epidermal hyperplasia and koilocytosis.…”

Section: Discussionmentioning

confidence: 99%

Collapsing Angiokeloidal Dermatofibroma

Schnebelen

Brown²,

Cheung

et al. 2012

The American Journal of Dermatopathology

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A heterogeneous group of benign fibrohistiocytic lesions has been assembled under the umbrella term, dermatofibroma. These lesions share a morphology of bland spindled cells encompassed by and intercalating through thick dermal collagen; unique variants have been described based on secondary histologic features, some of which include aneurysmal, myxoid, lipidized, signet ring, angiomatous, and keloidal. Here, we present a distinct dermatofibroma variant henceforth known as collapsing angiokeloidal dermatofibroma identified in 2 patients with slowly growing nodules of the buttock and the arm. Microscopically, the lesions have a characteristic dermatofibroma appearance but are accompanied by unusual diffuse small caliber vessels whose walls are collapsed by a thick, eosinophilic, keloid-like substance. The eosinophilic material resembles the adjacent dermal collagen; however, it does not stain for type-4 collagen or type-1 procollagen, amyloid, or glycogen. Although the exact composition of the keloidal material remains ambiguous, the architectural novelty of collapsing angiokeloidal dermatofibroma serves to further expand the morphologic spectrum of benign fibrous histiocytomas, although highlighting the difficulty in distinguishing between it and similar lesions.

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“…Considering our patient's history of self-paring tissue manipulation followed by infection and ulceration, reactive ESFA was the most likely diagnosis in this case. The suggested pathogenesis of reactive ESFA includes repeated eccrine duct trauma resulting in eccrine duct remodeling and repair 7 . Our patient demonstrates the first case of reactive ESFA in Korea.…”

Section: Discussionmentioning

confidence: 99%

“…However, malignant transformation to eccrine syringofibrocarcinoma and the association with squamous cell carcinoma has been reported in cases of ESFA 9 . A gradual increase in size, pain, ulcer and crust formation, and persistent lesions despite extensive treatments have been associated with malignant changes 7 .…”

Section: Discussionmentioning

confidence: 99%