Case and Research Letter
Ultrasound Image of Poroid Hidradenoma
Imagen ecográfica del hidroadenoma poroide
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Martínez-Morán, R. Khedaoui, B. Echeverría-García, J. Borbujo" "autores" => array:4 [ 0 => array:4 [ "nombre" => "C." "apellidos" => "Martínez-Morán" "email" => array:1 [ 0 => "cmmoran@salud.madrid.org" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "R." "apellidos" => "Khedaoui" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "B." "apellidos" => "Echeverría-García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "J." "apellidos" => "Borbujo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Imagen ecográfica del hidroadenoma poroide" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1443 "Ancho" => 1800 "Tamanyo" => 524027 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Histopathology: A, A solid-cystic lesion in the dermis. Hematoxylin and eosin (H&E), original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>20). B, Image showing the focal connection with the overlying epidermis. H&E, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>20). C, Poroid cells with scant cytoplasm, round or oval nuclei, and small nucleoli. H&E, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>400. D, Cuticular cells with abundant eosinophilic cytoplasm lining a duct lumen. H&E, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>400.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 57-year-old woman with allergy to codeine and a history of osteoporosis, systemic hypertension, allergic rhinitis, and anxiety. She was on treatment with metamizole, enalapril plus hydrochlorothiazide, ebastine, and alprazolam. She consulted for a stable, asymptomatic lesion that had arise approximately 4 years earlier on the right thigh and that had never been treated. Physical examination revealed a 7-mm–diameter, erythematous, desquamating papule with a central blood-stained scab (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A) on the lateral surface of the distal right thigh. Deep to the papule was a lesion of rubbery consistency measuring 15<span class="elsevierStyleHsp" style=""></span>mm in diameter (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">High-frequency skin ultrasound (15<span class="elsevierStyleHsp" style=""></span>MHz) was performed to determine whether this was a single lesion or 2 independent lesions (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A). B-mode ultrasound showed a well-defined, hypoechoic lesion in the subcutaneous cellular tissue; the lesion had a cystic appearance with a slightly more echogenic area on its right side. Immediately superficial to this cystic lesion, and in contact with it, was a well-defined, hypoechoic, exophytic dermal lesion. The epidermis was thickened. Doppler examination showed vessels at the periphery of the lesion, but not within it (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B). These findings supported the clinical suspicion of a single lesion, and it was excised en bloc.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Histopathology showed a mixed solid-cystic, nodular dermal lesion (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>A) that focally made contact with the epidermis (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>B). The nodule was formed of poroid cells with round or oval nuclei, small nucleoli, and scant cytoplasm (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>C). Between the poroid cells were occasional larger cuticular cells that frequently lined ductal lumens (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>D). There was no evidence of atypia, mitoses, or necrosis. Based on these findings we made a diagnosis of poroid hidradenoma.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Poroid hidradenoma is a variant of eccrine poroma, which belongs to the group of poroid tumors described in 1990 by Abenoza and Ackerman.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Those authors described the 4 histological variants of eccrine poroma: hidroacanthoma simplex, classic poroma, dermal duct tumor, and poroid hidradenoma, which was the tumor in our patient.</p><p id="par0025" class="elsevierStylePara elsevierViewall">To date, around 50 cases of poroid hidradenoma have been reported. Patient age varies between 13 and 86 years, with a peak in the sixth and seventh decades of life,<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,3</span></a> and a slight female predominance.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The tumor presents clinically as a solitary lesion, with no preferential anatomic site, though it has not been reported on the palms or soles. Clinical descriptions describe nonspecific cutaneous or subcutaneous lesions, polypoid nodules, or cysts of 1 to 2<span class="elsevierStyleHsp" style=""></span>cm diameter. The lesions are erythematous, reddish, or bluish in color and may be ulcerated.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Histopathology reveals structural elements of hidradenoma (solid-cystic areas), and cytologic features of poroma (poroid and cuticular cells, the latter cells showing ductal differentiation).<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In the literature reviewed, we have found no reports that describe the skin ultrasound features of poroid hidradenoma or of lesions with a similar appearance, with a cystic component with a more superficial papular component. In our case, ultrasound and histopathology findings were concordant: a cystic lesion connected to the overlying epidermis, suggesting this was a single lesion.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The prognosis is excellent and no cases of malignant change have been reported.</p><p id="par0050" class="elsevierStylePara elsevierViewall">As this is a neoplasm that arises in the dermis,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> the recommended treatment is complete radical excision of the lesion. En bloc surgical excision including the overlying epidermis and the surrounding adipose tissue, as was performed in our patient, prevents recurrence.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The benefit of performing ultrasound in our patient was the correlation between the clinical and histopathological findings: confirmation of the clinical suspicion of a dermal lesion connected to the epidermis and of benign appearance (peripheral vascularization on ultrasound) allowed us to plan en bloc surgical excision without margins.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Martínez-Morán C, Khedaoui R, Echeverría-García B, Borbujo J. Imagen ecográfica del hidroadenoma poroide. Actas Dermosifiliogr. 2016;107:350–352.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1126 "Ancho" => 1500 "Tamanyo" => 180258 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Erythematous papule overlying varices on the right thigh of a woman with chronic venous insufficiency. B, The subcutaneous component of the lesion can be observed.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 717 "Ancho" => 1950 "Tamanyo" => 129222 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Skin ultrasound shows a well-defined hypoechoic lesion. On the right side of the image there is a more hyperechoic area, which could correspond to the histologic image in Figure<span class="elsevierStyleHsp" style=""></span>3A. The lesion, located in the subcutaneous cellular tissue, had a cystic appearance and measured 11.24<span class="elsevierStyleHsp" style=""></span>mm. It showed posterior acoustic enhancement and oblique lateral shadows. B, Echo Doppler. Blood vessels are visible at the periphery of the lesion, but not within it.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1443 "Ancho" => 1800 "Tamanyo" => 524027 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Histopathology: A, A solid-cystic lesion in the dermis. Hematoxylin and eosin (H&E), original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>20). B, Image showing the focal connection with the overlying epidermis. H&E, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>20). C, Poroid cells with scant cytoplasm, round or oval nuclei, and small nucleoli. H&E, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>400. D, Cuticular cells with abundant eosinophilic cytoplasm lining a duct lumen. H&E, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>400.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Poromas. Neoplasms with eccrine differentiation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Abenoza" 1 => "B. Ackerman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:5 [ "fecha" => "1990" "paginaInicial" => "113" "paginaFinal" => "185" "editorial" => "Lea and Febiger" "editorialLocalizacion" => "Philadelphia" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "From hidroacanthoma simplex to poroid hidradenoma: Clinicopathologic and immunohistochemic study of poroid neoplasms and reappraisal of their histogenesis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Battistella" 1 => "L. Langbein" 2 => "B. Peltre" 3 => "B. Cribier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/DAD.0b013e3181bc91ff" "Revista" => array:6 [ "tituloSerie" => "Am J Dermatopathol" "fecha" => "2010" "volumen" => "32" "paginaInicial" => "459" "paginaFinal" => "468" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20571345" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Poroid hidradenoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Cho" 1 => "J.S. Kim" 2 => "J.H. Shin" 3 => "J.H. Kim" 4 => "H.J. Kim" 5 => "K.K. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 10 | 16 |
| 2024 October | 88 | 117 | 205 |
| 2024 September | 79 | 18 | 97 |
| 2024 August | 110 | 60 | 170 |
| 2024 July | 91 | 26 | 117 |
| 2024 June | 98 | 28 | 126 |
| 2024 May | 128 | 36 | 164 |
| 2024 April | 113 | 14 | 127 |
| 2024 March | 103 | 29 | 132 |
| 2024 February | 87 | 40 | 127 |
| 2024 January | 71 | 25 | 96 |
| 2023 December | 68 | 26 | 94 |
| 2023 November | 94 | 29 | 123 |
| 2023 October | 104 | 25 | 129 |
| 2023 September | 80 | 31 | 111 |
| 2023 August | 78 | 16 | 94 |
| 2023 July | 108 | 31 | 139 |
| 2023 June | 77 | 29 | 106 |
| 2023 May | 73 | 27 | 100 |
| 2023 April | 62 | 18 | 80 |
| 2023 March | 53 | 25 | 78 |
| 2023 February | 57 | 31 | 88 |
| 2023 January | 53 | 36 | 89 |
| 2022 December | 48 | 48 | 96 |
| 2022 November | 44 | 30 | 74 |
| 2022 October | 31 | 19 | 50 |
| 2022 September | 24 | 32 | 56 |
| 2022 August | 31 | 29 | 60 |
| 2022 July | 32 | 33 | 65 |
| 2022 June | 26 | 23 | 49 |
| 2022 May | 45 | 45 | 90 |
| 2022 April | 61 | 28 | 89 |
| 2022 March | 46 | 39 | 85 |
| 2022 February | 40 | 32 | 72 |
| 2022 January | 50 | 28 | 78 |
| 2021 December | 46 | 36 | 82 |
| 2021 November | 59 | 40 | 99 |
| 2021 October | 55 | 40 | 95 |
| 2021 September | 49 | 45 | 94 |
| 2021 August | 43 | 32 | 75 |
| 2021 July | 45 | 31 | 76 |
| 2021 June | 37 | 35 | 72 |
| 2021 May | 41 | 33 | 74 |
| 2021 April | 72 | 28 | 100 |
| 2021 March | 76 | 32 | 108 |
| 2021 February | 66 | 34 | 100 |
| 2021 January | 42 | 18 | 60 |
| 2020 December | 38 | 13 | 51 |
| 2020 November | 17 | 26 | 43 |
| 2020 October | 22 | 13 | 35 |
| 2020 September | 31 | 10 | 41 |
| 2020 August | 20 | 17 | 37 |
| 2020 July | 21 | 16 | 37 |
| 2020 June | 39 | 30 | 69 |
| 2020 May | 24 | 17 | 41 |
| 2020 April | 26 | 25 | 51 |
| 2020 March | 24 | 19 | 43 |
| 2020 February | 3 | 0 | 3 |
| 2020 January | 4 | 0 | 4 |
| 2019 December | 8 | 0 | 8 |
| 2019 November | 4 | 0 | 4 |
| 2019 September | 10 | 0 | 10 |
| 2019 August | 4 | 0 | 4 |
| 2019 July | 2 | 0 | 2 |
| 2019 June | 4 | 0 | 4 |
| 2019 May | 3 | 0 | 3 |
| 2019 April | 0 | 2 | 2 |
| 2019 March | 0 | 3 | 3 |
| 2019 February | 2 | 0 | 2 |
| 2018 December | 4 | 0 | 4 |
| 2018 November | 2 | 0 | 2 |
| 2018 October | 7 | 0 | 7 |
| 2018 September | 6 | 0 | 6 |
| 2018 February | 13 | 5 | 18 |
| 2018 January | 42 | 5 | 47 |
| 2017 December | 41 | 6 | 47 |
| 2017 November | 24 | 5 | 29 |
| 2017 October | 37 | 5 | 42 |
| 2017 September | 26 | 10 | 36 |
| 2017 August | 32 | 9 | 41 |
| 2017 July | 20 | 11 | 31 |
| 2017 June | 28 | 18 | 46 |
| 2017 May | 25 | 8 | 33 |
| 2017 April | 22 | 4 | 26 |
| 2017 March | 13 | 41 | 54 |
| 2017 February | 12 | 5 | 17 |
| 2017 January | 13 | 6 | 19 |
| 2016 December | 27 | 14 | 41 |
| 2016 November | 27 | 17 | 44 |
| 2016 October | 16 | 15 | 31 |
| 2016 September | 1 | 18 | 19 |
| 2016 August | 0 | 2 | 2 |
| 2016 July | 0 | 1 | 1 |
| 2016 June | 0 | 5 | 5 |
| 2016 May | 0 | 1 | 1 |
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