A rare case of multiple segmental eccrine spiradenomas

Abstract

Eccrine spiradenoma is a benign adnexal neoplasm that has been historically designated as a tumor of eccrine differentiation, although current reconsideration indicates an apocrine process. It usually presents on the trunk and extremities as a tender dermal or subcutaneous papule or nodule frequently with a pink or blue hue. The clinical picture is often not distinct and biopsy is required for diagnosis. Eccrine spiradenoma can present in a variety of ways, including as tumors arranged in zosteriform/dermatomal and/or blaschkoid distributions, often precluding a straightforward diagnosis. Proper diagnosis of eccrine spiradenoma is important due to the occurrence of potentially life-threatening malignant transformation. This article illustrates a rare presentation of eccrine spiradenoma with a concise review for the dermatologist.

Figure 1

Multiple, well-circumscribed, subcutaneous, blue-gray nodules of various sizes in a segmental distribution across the right chest and arm

Figure 2

A large, well-circumscribed nodule over the right arm as seen during excision

Figures 3A and 3B

A) Overlying normal epidermis with underlying multiple, well-circumscribed, dermal nodules consisting of basophilic cells (hematoxylin-eosin [H&E], magnification 20X). B) Increased powered view of a dermal nodule with cords of basaloid cells arranged in a trabecular pattern with eosinophilic fibrous strands and numerous lymphocytes (H&E, magnification 40x).

Figures 3A and 3B

A) Overlying normal epidermis with underlying multiple, well-circumscribed, dermal nodules consisting of basophilic cells (hematoxylin-eosin [H&E], magnification 20X). B) Increased powered view of a dermal nodule with cords of basaloid cells arranged in a trabecular pattern with eosinophilic fibrous strands and numerous lymphocytes (H&E, magnification 40x).

Figure 4

High-powered view demonstrating small, dark, basaloid cells with hyperchromatic nuclei, larger cells with pale nuclei in the center of the clusters, and numerous scattered lymphocytes seen throughout (H&E, magnification 100x)