Porom eccrinesD23.L

Author:Prof. Dr. med. Peter Altmeyer

Co-Autor:Dr. Michael Hambardzumyan

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Last updated on: 25.01.2023

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Synonym(s)

Acrospirome; Borst-Jadasson epithelioma; dermal duct tumor; Eccrine Poroma; Poroakanthoma

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HistoryThis section has been translated automatically.

Pinkus, 1956. Originally, poroma was defined by Pinkus et al. as a poroid (terminal ductal) differentiated epithelioma of eccrine origin. Further reports have described cases with apocrine, sebaceous, and follicular differentiation (Horenstein MG et al. 2018).

DefinitionThis section has been translated automatically.

The term "Porom" is misleading, historically overloaded and is still interpreted differently today. The definition is generally accepted: benign adnexal tumor with "eccrine" (and apocrine) differentiation, which probably originates from a pluripotent stem cell at the transition from the dermal to the intraepidermal part of the glandular duct.

ClassificationThis section has been translated automatically.

Eccrine poromas may develop intraepidermally (intraepidermal poroma - historical name: hidroacanthoma simplex, see also Borst-Jadassohn phenomenon).

A second type grows into the papillary epidermis in broad adherence to the surface epithelium, broad-based solid or reticular (juxtapidermal eccrine poroma).

A third type is dermal eccrine poroma, which spreads quite predominantly in the dermis, without a broad relationship to the surface epithelium. The term "dermal duct tumor" was also commonly used for dermal eccrine poroma.

Occurrence/EpidemiologyThis section has been translated automatically.

The proportion of all sweat gland tumours is about 10%.

ManifestationThis section has been translated automatically.

40th to 60th year of age, especially in men.

LocalizationThis section has been translated automatically.

Mainly localized on the soles of the feet, palms of the hands, less frequently on the head and neck, also on the remaining integument (Sawaya JL et al. 2014). Exceptional is the multiple occurrence (eccrine poromatosis).

Clinical featuresThis section has been translated automatically.

Little characteristic clinical picture. Solitary, asymptomatic, sharply circumscribed, raised, 1-4 mm to 3 cm in size, sometimes pedunculated, possibly slightly reddened, unpigmented, broad-based nodule or lump or a corresponding plaque. The usually unpigmented tumor is skin-colored to brownish-red in color. Especially in cystic forms, a blue-black discoloration may occur as a result of hemorrhage. Eccrine poromas may occur together with a nevus sebaceus or develop secondarily in a n. sebaceus. The rare occurrence of multiple poromas in acral skin is called poromatosis.

HistologyThis section has been translated automatically.

Demarcated compact or reticular, uniform cell proliferation from cuboidal keratinocytes with small, hyperchromatic nuclei and a uniform eosinophilic, glycogen-rich (PAS-positive) cytoplasm. In sections, light cell complexes are also found. The poroma may express tubular structures (less commonly ductal). In the case of ductal differentiation, carcinoembryogenic antigen (CEA) is detectable. In tubular structures, decapitation phenomena can often be detected (indicating an apocrine genesis of this poroma). The tumor parenchyma is surrounded by a hyalinized stroma.

Circumscribed beet-like cell necrosis in malignant (not in eccrine poroma!) tumors is frequent (necrosis en masse) and should be regarded as an indication of their malignancy, since perfusion is no longer guaranteed due to rapid growth, resulting in a reduced supply of cell necrosis. Focally, ductal structures differentiate. Rare are sebocytic differentiations at the base of the tumor.

Differential diagnosisThis section has been translated automatically.

TherapyThis section has been translated automatically.

It is a histological incidental diagnosis. Excision with a safety margin of 1-2 mm is curative. Alternatively, there are single case reports that topical therapy with 5% imiquimod (3x/week for 4 weeks) is also effective.

Progression/forecastThis section has been translated automatically.

Favourable; rarely a malignant degeneration into a porocarcinoma can be observed.

Note(s)This section has been translated automatically.

The additional name "eccrine" is widely used in the current literature and is still used here in contrast to follicular poroma. However, the addition "eccrine" is incorrect, as only about half of the "eccrine" poromes are of eccrine origin. The rest is apocrine. Some authors use the term acrospiroma as an umbrella term for the hidroakanthoma simplex and the eccrine poroma. This term is also dispensable.

LiteratureThis section has been translated automatically.

  1. Del Pozo J et al. (1999) Porokeratotic eccrine ostial and dermal duct naevus: treatment with carbon dioxide laser. Br J Dermatol 141: 1144-1145
  2. Dogra S et al. (2002) Porokeratotic eccrine ostial and dermal duct nevus: unilateral systematized involvement. Pediatr Dermatol 19: 568-569
  3. Eckert F et al (1991) The eccrine poroma. Dermatologist 42: 692-699
  4. Kamiya H et al (2001) Apocrine poroma: review of the literature and case report. J cutan Pathol 28: 101-104
  5. Holden B et al (2002) Malignant eccrine acrospiroma with metastasis to the parotid. Ear Nose Throat J 81: 352-155.
  6. Horenstein MG et al (2018) Holocrine poroma: a distinctive adnexal tumor. Am J Dermatopathol 40:401-408.
  7. Kakinuma H et al (2002) Eccrine poroma: another cause of a pigmented scalp nodule. Br J Dermatol 146: 523
  8. Kuo HW et al (2003) Pigmented eccrine poroma: a report of two cases and study with dermatoscopy. Dermatol Surg 29: 1076-1079
  9. Kurokawa M et al (2001) Eccrine poromas in a patient with mycosis fungoides treated with electron beam therapy. Br J Dermatol 145: 830-833
  10. Mahalingam M, Byers HR (2000) Intra-epidermal and intra-dermal sebocrine adenoma with cystic degeneration and hemorrhage. J Cutan Pathol 27: 472-475
  11. Pinkus H, Rogin JR, Goldman P (1956) Eccrine poroma. Arch Dermatol 74: 511-521
  12. Reier AR et al (2002) MR imaging appearance of plantar eccrine acrospiroma (sweat gland tumor). AJR Am J Roentgenol 179: 1079-1080
  13. Sassmannshausen J et al (2000) Porokeratotic eccrine ostial and dermal duct nevus: a case report and review of the literature. J Am Acad Dermatol. 43: 364-367
  14. Sawaya JL et al (2014) Poroma: a review of eccrine, apocrine, and malignant forms. Int J Dermatol 53:1053-1061.

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Last updated on: 25.01.2023