Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.
Porphyria and Rare Diseases Unit, San Gallicano Dermatological Institute - IRCCS, Rome, Italy.
Exp Dermatol. 2022 Nov;31(11):1779-1790. doi: 10.1111/exd.14658. Epub 2022 Aug 19.
Eccrine poroma (EP) is a rare benign adnexal tumor that may mimic benign or malignant tumors and differential diagnosis may be difficult under clinical and dermoscopic examination. Reflectance confocal microscopy (RCM) examination may add important information to diagnosis and subsequent management of solitary lesions for which dermoscopy can be challenging. The aim of the present study was to investigate features of EP at RCM in order to detect the characteristics that might aid in the differential diagnosis of EP versus other solitary lesions (benign or malignant). Secondary objective was to correlate the resulting features with histopathological findings. This monocentric retrospective observational case-control study included all EPs registered with RCM between January 2007 and May 2018. Control cases were benign or malignant lesions similar in clinical appearance, morphology, and dermoscopic features to EPs. RCM evaluators were blinded to clinical-dermoscopic images and to final histopathological diagnoses. Finally, RCM-histopathological correlation was performed. A total of 11 EPs and 33 controls were included in the present study. Among RCM parameters, "cords without palisading," "dark holes," "prominent vascularization" and "abundant stroma" resulted positively associated with EP in univariate analysis. RCM features correspond to the histopathological diagnosis of EP in 97% of cases, as illustrated by the cluster analysis. An excellent correlation between diagnostic features of conventional histopathology and RCM was observed. RCM assists in the differential diagnosis of solitary lesions, allowing to reach a correct diagnosis of EP through the identification of its four characteristics.
汗管瘤 (EP) 是一种罕见的良性附属器肿瘤，在临床和皮肤镜检查下可能与良性或恶性肿瘤相混淆，鉴别诊断可能较为困难。反射共聚焦显微镜 (RCM) 检查可为难以进行皮肤镜检查的孤立性病变的诊断和后续管理提供重要信息。本研究的目的是探讨 RCM 中 EP 的特征，以发现有助于 EP 与其他孤立性病变（良性或恶性）鉴别诊断的特征。次要目的是将得到的特征与组织病理学发现相关联。本单中心回顾性病例对照研究纳入了 2007 年 1 月至 2018 年 5 月期间所有使用 RCM 登记的 EP。对照病例为临床外观、形态和皮肤镜特征与 EP 相似的良性或恶性病变。RCM 评估者对临床皮肤镜图像和最终组织病理学诊断均不知情。最后，进行了 RCM-组织病理学相关性分析。本研究共纳入 11 例 EP 和 33 例对照。在 RCM 参数中，“无栅栏状的条索”、“暗孔”、“明显的血管化”和“丰富的基质”在单因素分析中与 EP 呈正相关。聚类分析表明，RCM 特征与 EP 的组织病理学诊断相符，在 97%的病例中。观察到常规组织病理学诊断特征与 RCM 之间具有极好的相关性。RCM 有助于孤立性病变的鉴别诊断，通过识别 EP 的四个特征，可得出正确的 EP 诊断。
