Eccrine poroma: causes, symptoms, diagnosis, treatment

The term "ekrinnaya poroma" was first proposed by N. Pinkus et al. (1956) for the designation of a benign tumor histogenetically associated with the intra-epidermal part of the duct of the sweat gland, the so-called acrosiringum.

Symptoms of ekkrinnoy gunpowder. The tumor occurs mainly on the skin of the extremities, although the localization can be very different. The average age of patients is 67 years. It is assumed that the ratio of patients of different sex is approximately equal or there is a certain predominance of men. Duration of the tumor from several months to 10 years or more. The tumor is mostly solitary, less often multiple. Usually, the tumor appears on intact skin, however, there are observations of the appearance of a tumor against a background of chronic post-radial dermatitis.

Clinically, the tumor manifests itself in a nodule skin color with a diameter of no more than 1-2 cm with a smooth, shiny surface and telangiectasias. The color is pale pink or dark red, sometimes dark brown. The surface of the tumor can be with peeling, papillomatosis, uneven hyperkeratosis. G. Burg (2000) observed the rock in the form of an exophytic lobate node with erosion sites.

Pathomorphology of the eccrine powder. The tumor consists of solid growths or anastomosing cords of monomorphic, small, basaloid-type cells with basophilic nuclei and a moderately expressed pale or slightly basophilic cytoplasm. The cells are connected by intercellular bridges. Within the strata of tumor cells, there are ductal structures with a PAS-positive cuticle and cystic enlargement. There are small foci with signs of keratinization, a layer of connective tissue with loans and lymphohistiocytic infiltration.

Histochemically, enzymes are found in tumor cells. Typical for eccrine differentiation cells, such as phosphorylase and succinate dehydrogenase, as well as glycogen, as in the epithelial cells of ducts of embryonic eccrine glands.

Electron microscopy revealed that the bulk of tumor cells have clear signs of flat epithelium. In the cytoplasm are bundles of tonofilaments, plasma membranes form narrow thin plasma outgrowths that, with the help of numerous desmosomes, contact the analogous outgrowths of neighboring cells. Concentrically located cells form ductal structures on the luminal surface of which numerous short, densely located microvilli are visible. Quite typical is the presence of flat-epithelial cells with intra-cytoplasmic ducts located centrally, with microvilli lining the lumen and surrounded by thick bundles of tonofilaments.

Histogenesis. The association of the porcine with the acrosiringum confirms the histological, histochemical and ultrastructural data given above.

Differentiate the ecrine powder primarily from seborrheic keratoma. Unlike the latter, the powder does not contain horny cysts and melanin. From basalioma, ekkrinnaya poroma differs in the absence of palisad-like structures characteristic for basalioma, the presence of intercellular bridges and the characteristic activity of enzymes typical for eccrine structures.

[1], [2], [3], [4], [5], [6], [7]