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LETTER TO EDITOR
Year : 2013  |  Volume : 14  |  Issue : 1  |  Page : 44-45

Eccrine angiomatous hamartoma: A rare entity


Department of Pathology, North Bengal Medical College, Sushrutanagar, Darjeeling, North Bengal, India

Date of Web Publication23-Aug-2013

Correspondence Address:
Indranil Chakrabarti
Department of Pathology, North Bengal Medical College, Sushrutanagar, Darjeeling - 734 012, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-7250.116864

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How to cite this article:
Chakrabarti I, Giri A. Eccrine angiomatous hamartoma: A rare entity. Indian J Paediatr Dermatol 2013;14:44-5

How to cite this URL:
Chakrabarti I, Giri A. Eccrine angiomatous hamartoma: A rare entity. Indian J Paediatr Dermatol [serial online] 2013 [cited 2019 Dec 10];14:44-5. Available from: http://www.ijpd.in/text.asp?2013/14/1/44/116864

Sir,

Eccrine angiomatous hamartoma (EAH) is an uncommon benign hamartomatous lesion of skin, which is characterized by the proliferation of eccrine sudoriparous glands and thin walled capillaries. Other proliferating tissues include hair follicles, epidermis and adipose tissue.

A 10-year-old boy presented with a brownish nodule in front of the right leg for last 1 year. On enquiry, patient stated that the lesion was mildly painful and 4 months back, there was bleeding from the site on receiving trauma to the nodule. The nodule was progressing slowly since then and was hyperhidrotic. On examination, a single, well-demarcated, brown-black nodule measuring 3.5 cm Χ 3 cm was seen just below and lateral to the right tibial tuberosity. It was tender on compression and clinically a diagnosis of eccrine nevus with differential diagnosis of angiomatous malformation was made. The nodule was excised and was sent for histopathological examination [Figure 1]. The subsequent histopathology showed a normal appearing epidermis with proliferation of eccrine sweat glands and thin walled capillaries in the dermis along with adipose tissue, few muscle and nerve fibers. A histological diagnosis of EAH was made based on these findings.
Figure 1: Microphotograph showing proliferation of eccrine sweat glands (black arrow), blood vessels and adipose tissue in the dermis. One dilated vessel is shown by the white arrow. (H and E; ×100) inset
shows another area with predominant vascular proliferation (white arrow) (H and E; ×400)


Click here to view


Probably first described by Lotzbeck, in 1859 as an angiomatous lesion over the malar region of a child, it was Hyman et al. who coined the term EAH. [1],[2] Most cases occur at birth or in early childhood with no specific gender predilection, but occurrences have been reported in adults. The lesions are usually solitary, rarely multiple and may present as erythematous plaque/macules, papules or angiomatous nodules. Pain, hyperhidrosis are common symptoms, but up to one-third cases have been seen to be asymptomatic. [2],[3] EAH have a preference for distal extremities and some cases have shown an association with other vascular tumors. [4] The pain can be a result of hormonal influence, but in general is attributed to involvement of local nerve fibers while hyperhidrosis appears to be a result of stimulation of the sweat glands. [2],[3] The differential diagnosis includes various vascular malformations, hamartoma of the smooth muscles, glomus tumor, mastocytosis, telangiectasia macularis and tufted angioma all which can be differentiated by their respective characteristic histopathological and immunohistochemical

features. [2],[5] The treatment of these lesions is surgical and is reserved for symptomatic cases or for esthetic reasons. In the present case, surgical excision proved to be curative and the patient was asymptomatic on

follow-up.

 
  References Top

1.Hyman AB, Harris H, Brownstein MH. Eccrine angiomatous hamartoma. N Y State J Med 1968;68:2803-6.  Back to cited text no. 1
[PUBMED]    
2.Pinheiro AM, Ribeiro AM, Rodrigues HA. Eccrine angiomatous hamartoma and clinical, pathologic and ultrasonographic studies. An Bras Dermatol 2005;80:377-80.  Back to cited text no. 2
    
3.García-Arpa M, Rodríguez-Vázquez M, Cortina-de la Calle P, Romero-Aguilera G, López-Pérez R. Multiple and familial eccrine angiomatous hamartoma. Acta Derm Venereol 2005;85:355-7.  Back to cited text no. 3
    
4.Cheong SH, Lim JY, Kim SY, Choi YW, Choi HY, Myung KB. A case of eccrine angiomatous hamartoma associated with verrucous hemangioma. Ann Dermatol 2009;21:304-7.  Back to cited text no. 4
[PUBMED]    
5.Pelle MT, Pride HB, Tyler WB. Eccrine angiomatous hamartoma. J Am Acad Dermatol 2002;47:429-35.  Back to cited text no. 5
[PUBMED]    


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