Eccrine naevus: case report and literature review

Eccrine Nevus on the Neck: A Case Report and Review of the Literature

Eccrine nevus is an extremely rare benign cutaneous hamartoma that usually occurs in childhood and adolescence. It has a wide range of clinical manifestations, and histological findings reveal a proliferation of structurally normal eccrine ducts. Herein, we present a case of eccrine nevus on the neck of an 8-year-old girl. Our literature review reveals that the head and neck region is a rare anatomical location for eccrine nevus as it has a predilection for extremities. Our review also suggests that overlying skin changes are common in eccrine nevus regardless of accompanying localized hyperhidrosis.

Two patients with localised hyperhidrosis of the hand based on functional and structural abnormalities of sweat glands

A 14-year-old girl and a 30-year-old woman presented with localised hyperhidrosis on the dorsal hand and wrist, respectively, provoked by different stimuli such as physical activity and minor trauma to the skin. The skin was seemingly normal in both patients where an iodine-starch test revealed a well-demarcated area of hyperhidrosis. Following histopathological examination, the diagnosis was unilateral localised hyperhidrosis in both cases; one with normal histology and one with a nevus sudoriferous. Both patients were successfully treated with botulinum toxin type A. The 30-year-old woman additionally used low-dose propantheline bromide periodically and experienced long-term remission on this therapy. Hyperhidrosis may embarrass and interfere with patients' school and careers, and it is therefore important to tailor an effective individual treatment.

Eccrine Nevus Presenting with Umbilical Discharge: A Case Report and Review of the Literature

Eccrine nevus is a rare skin lesion with protean manifestations like hyperhidrosis, discolored nodules, papules, and so forth, which has been reported in various anatomic parts of the body including the forearm, leg, thigh, back, and coccyx. Our patient was a 26-year-old male, who presented with increasing colorless and odorless episodic umbilical discharge. First impression for the patient was an umbilical sinus and the patient underwent surgery. Histopathological study revealed the lesion to be an eccrine nevus of the umbilicus. This is the first case of eccrine nevus presenting with umbilical discharge. We recommend that eccrine nevus should be considered as a differential diagnosis for umbilical discharge.

Eccrine nevus affecting the forearm of an 11-year-old girl successfully controlled with topical glycopyrrolate

Eccrine nevi are rare lesions characterized by a sharply demarcated area of localized hyperhidrosis. We present an 11-year-old girl with an eccrine nevus on her right lower forearm. To the best of our knowledge, this is the first case successfully controlled with topical glycopyrrolate wipes.

Mucinous Eccrine Nevus

A 46-year-old man with an erythematous, tender, swollen patch on the dorsum of his left fourth toe visited us. The biopsied tissue showed a proliferation of normally structured eccrine glands and ducts surrounded with abundant materials confirmed as mucin by toluidine blue stain. Mucinous eccrine nevus is an extremely rare entity, and only two cases have been reported in the literature. We describe a case of mucinous eccrine nevus which was late in onset and presented as a swollen patch.

Mucinous eccrine naevus: case report and review of the literature

Mucinous eccrine naevus (MEN) is an extremely rare variant of eccrine naevus. There are only nine reported cases in the English literature. We report a 3-month-old boy with a congenital lesion on the lower back, and review the other cases in the literature. In most cases, MEN presents before puberty. The commonest presentation is a unilateral, solitary, brownish nodule without hyperhidrosis occurring on the legs. The diagnosis of this condition is confirmed by the characteristic histopathological features. Treatment options may be considered if symptomatic.

Unique case: syringocystadenoma papilliferum associated with an eccrine nevus

Syringocystadenoma papilliferum is a benign adnexal lesion of the skin most commonly found in the head and neck region. It is frequently seen in association with other benign adnexal lesions. We report a case of syringocystadenoma papilliferum seen in conjunction with an eccrine nevus. To our knowledge, this association has not been previously documented in the literature.

A unique presentation of eccrine hamartoma: eccrine nevus with abnormal eccrine structures and angiomyxoid stroma

Eccrine hamartomas are very rare lesions usually presenting in early childhood, with variable clinical presentations. Local hyperhidrosis is often noticed. These lesions are all characterized by an increase in number and/or size of normal eccrine glands. We report the case of a hamartomatous lesion composed of eccrine structures and prominent angiomyxoid stroma, diagnosed in a 9-year-old girl. In this lesion, eccrine structures were not normal eccrine coils or ducts but ramified strands of small eosinophilic cells, containing a few eccrine ducts. These epithelial structures expressed carcinoembryonic antigen, cytokeratin 14, and cytokeratin 77, in a pattern suggesting ductal eccrine differentiation. The mesenchymatous component contained numerous capillary vessels in an abundant myxoid stroma. It was organized concentrically around the epithelial structures. This angiomyxoid stroma was somewhat reminiscent of mucinous eccrine nevi and eccrine angiomatous hamartomas. We propose to describe this unique lesion inside the group of eccrine nevi with the term "angiomyxoid eccrine nevus."

Eccrine nevus presenting as a hypopigmented patch

A 14-month-old Caucasian male presented with a hypopigmented patch associated with increased perspiration on the right side of his back, flank, and abdomen. Starch iodide test and biopsy revealed an eccrine nevus. The truncal presentation and light color both were unique presentations of this rare hamartoma.

A Case of Eccrine Nevus

Eccrine nevi are very rare cutaneous lesions which may or may not be accompanied by localized hyperhidrosis. Histological findings usually reveal a slightly increased number of eccrine glands without any other abnormalities. Herein we present a case of eccrine nevus not associated with localized hyperhidrosis on the left wrist of a 6-year-old girl. The lesion was a brownish, ovoid plaque approximately 1.0 × 1.5 cm in size, with a hyperkeratotic, slightly scaly papule in the center. It was treated by surgical excision.

Eccrine nevus

Localized hyperhidrosis on the left forearm of a 7-year-old girl is described. Biopsy revealed an eccrine nevus. The differential diagnosis of localized hyperhidrosis is discussed.

Complementary medicine and psoriasis: linking the patient's outlook with evidence-based medicine

BACKGROUND

There is increasing evidence for the extensive use of complementary and alternative medicine (CAM) by patients with psoriasis. Clinical research in the arena of CAM and psoriasis treatment is evolving and includes some randomized controlled trials.

OBJECTIVE

To study CAM use among patients with psoriasis attending a dermatology clinic in a major university hospital in northern Israel. Prevalence, reasons for CAM use and its relevance to doctor-patient communication were emphasized.

METHODS

Semistructured interviews were conducted with psoriasis patients in a dermatology clinic. Consent was obtained for 78 patients. Post-visit questionnaires were given to 5 physicians.

RESULTS

Seventy-eight patients with psoriasis were interviewed and 77 were studied. Sixty-two percent used CAM. Fifty-eight percent of users had seen a CAM practitioner. The study found a trend of CAM use among patients with psoriasis from Arab compared to Jewish descent (p=0.087). CAM users reported on average 2 different CAM modalities. Herbal medicine and nutritional treatments ranked first, followed by homeopathy, traditional Chinese medicine and nutritional supplements. The main reason for CAM use was stated to be to do everything to heal the disease, followed by a quest for improved quality of life. Others mentioned an interest in a less toxic treatment, disappointment with conventional treatment and stress reduction. Well over half of the study participants and their dermatologists did not initiate a discussion about CAM use. The dermatologists' ability to predict CAM use in their patients was relatively low.

CONCLUSION

There is growing evidence of extensive CAM use among patients with psoriasis. Most patients use CAM as a complementary treatment, rather than an alternative to conventional treatment. Teaching CAM should be integrated into the dermatology residency curriculum. Dermatologists need to increase their awareness of CAM use by their patients in order to improve therapeutic communication.