Notsu Hiroshi, Goto Hiroyuki, Tani Naomi, Sugita Kazunari
Division of Dermatology, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan.
Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga 849-0937, Japan.
Yonago Acta Med. 2023 Jul 18;66(3):380-381. doi: 10.33160/yam.2023.08.004. eCollection 2023 Aug.
A 71-year-old woman was referred to our clinic with a 2-month history of pain and exudate from her right first toe. Physical examination revealed a subungual nodule that elevated the nail plate and produced distal onycholysis. We performed onychectomy and removed the nodule. A histopathological specimen from the nodule showed hyperkeratosis and acanthosis in the epidermis, papillomatosis and dilated vessels in the superficial dermis, and aggregation of eccrine glands in the mid-dermis. Based on these findings, a diagnosis of eccrine angiomatous hamartoma (EAH) was made. EAH is a rare cutaneous hamartoma that is histologically characterized by proliferation of eccrine glands and vascular components. To our knowledge, EAH occurring in the subungual region has not been reported. The pathogenesis of acquired EAH has not been completely elucidated, but several cases have been reported to be caused by external stimuli. Although the subungual area generally has no sweat glands, our case suggests that a traumatic stimulus can induce EAH anywhere including regions where sweat glands are normally not found.
一名71岁女性因右足第一趾疼痛及渗出2个月转诊至我院门诊。体格检查发现甲下有一结节,该结节使甲板抬高并导致远端甲剥离。我们进行了甲切除术并切除了结节。结节的组织病理学标本显示表皮有角化过度和棘层肥厚,真皮浅层有乳头瘤样增生和血管扩张,真皮中层有汗腺聚集。基于这些发现,诊断为小汗腺血管瘤性错构瘤(EAH)。EAH是一种罕见的皮肤错构瘤,其组织学特征为小汗腺和血管成分增生。据我们所知,尚未有甲下区域发生EAH的报道。后天性EAH的发病机制尚未完全阐明,但已有数例报道称是由外部刺激引起的。虽然甲下区域通常没有汗腺,但我们的病例表明,创伤性刺激可在任何部位诱发EAH,包括正常无汗腺的区域。