A case of eccrine angiomatous hamartoma associated with verrucous hemangioma

Abstract

Eccrine angiomatous hamartomas are benign vascular and eccrine malformations often accompanied by hyperhidrosis or pain, increased eccrine glands, and aggregates of vessels. Verrucous hemangiomas are congenital vascular malformations presenting as unilateral grouped papules. Histologically, they show verrucous epidermal change and proliferation of capillaries in the dermis. We report a case of a 47-year-old woman with a red keratotic patch overlying a bluish plaque on the right sole, which had been present since birth. It was accompanied by pain and hyperhidrosis. Histologically, there were verrucous changes in the epidermis, numerous dilated capillaries in the papillary dermis, and increased eccrine glands with angiomatous foci in the deep dermis. The epithelial cells of the eccrine glands were positive for CEA, and the endothelial cells were positive for CD31 and GLUT-1. Eccrine angiomatous hamartomas have been reported in conjunction with other vascular tumors in only a few instances. We report an interesting case of an eccrine angiomatous hamartoma associated with a verrucous hemangioma.

Keywords: Eccrine angiomatous hamartoma; Verrucous hemangioma.

Fig. 1

An erythematous keratotic plaque overlying a bluish, ill-defined plaque on the right sole.

Fig. 2

Epidermal hyperplasia, an increased number of vessels in the superficial dermis, and eccrine structures with intermingled vascular channels in the deep dermis (H&E, ×20).

Fig. 3

(A) Verrucous changes in the epidermis and numerous dilated capillaries in the papillary dermis (H&E, ×40). (B) Increased eccrine glands with angiomatous foci in the deep dermis (H&E, ×100).

Fig. 4

Epithelial cells in the eccrine glands are positive for CEA (A: ×40, B: ×400).

Fig. 5

Endothelial cells in the vessel wall are positive for CD31 and GLUT-1 (A: CD31, ×40, B: CD31, ×400, C, D: GLUT-1, ×400).