array:24 [
  "pii" => "S1578219018301641"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2018.05.007"
  "estado" => "S300"
  "fechaPublicacion" => "2018-07-01"
  "aid" => "1783"
  "copyright" => "Elsevier España, S.L.U. and AEDV"
  "copyrightAnyo" => "2017"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2018;109:543-4"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 4
    "formatos" => array:3 [
      "EPUB" => 1
      "HTML" => 2
      "PDF" => 1
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0001731017304970"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2017.01.023"
      "estado" => "S300"
      "fechaPublicacion" => "2018-07-01"
      "aid" => "1783"
      "copyright" => "AEDV"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2018;109:543-4"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 116
        "formatos" => array:2 [
          "HTML" => 74
          "PDF" => 42
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Casos para el diagn&#243;stico</span>"
        "titulo" => "P&#225;pula eritematosa pediculada en la rodilla"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "543"
            "paginaFinal" => "544"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Erythematous Pedunculated Papule on the Knee"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0015"
            "etiqueta" => "Figura 3"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr3.jpeg"
                "Alto" => 571
                "Ancho" => 750
                "Tamanyo" => 183266
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxilina-eosina &#215;10&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46;C&#46; Garc&#237;a del Pozo, C&#46; Mart&#237;n de Hijas, L&#46; I&#241;&#237;guez"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "M&#46;C&#46;"
                "apellidos" => "Garc&#237;a del Pozo"
              ]
              1 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Mart&#237;n de Hijas"
              ]
              2 => array:2 [
                "nombre" => "L&#46;"
                "apellidos" => "I&#241;&#237;guez"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219018301641"
          "doi" => "10.1016/j.adengl.2018.05.007"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018301641?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017304970?idApp=UINPBA000044"
      "url" => "/00017310/0000010900000006/v1_201808010427/S0001731017304970/v1_201808010427/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S157821901830163X"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2018.05.006"
    "estado" => "S300"
    "fechaPublicacion" => "2018-07-01"
    "aid" => "1782"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2018;109:545-6"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1
      "PDF" => 1
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case for Diagnosis</span>"
      "titulo" => "Annular and Polycyclic Lesions on the Lower Limbs"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "545"
          "paginaFinal" => "546"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Lesiones anulares y polic&#237;clicas en miembros inferiores"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:6 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 750
              "Ancho" => 1000
              "Tamanyo" => 77800
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "V&#46; Velasco-Tamariz, J&#46;L&#46; Rodr&#237;guez-Peralto, A&#46; Guerra-Tapia"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Velasco-Tamariz"
            ]
            1 => array:2 [
              "nombre" => "J&#46;L&#46;"
              "apellidos" => "Rodr&#237;guez-Peralto"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Guerra-Tapia"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731017304969"
        "doi" => "10.1016/j.ad.2017.02.036"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017304969?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821901830163X?idApp=UINPBA000044"
    "url" => "/15782190/0000010900000006/v1_201808010420/S157821901830163X/v1_201808010420/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1578219018301720"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2018.05.014"
    "estado" => "S300"
    "fechaPublicacion" => "2018-07-01"
    "aid" => "1750"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2018;109:e42-6"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3
      "formatos" => array:2 [
        "HTML" => 1
        "PDF" => 2
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">e- Case Report</span>"
      "titulo" => "Juvenile Dermatomyositis&#58; Key Roles of Muscle Magnetic Resonance Imaging and Early Aggressive Treatment"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "e42"
          "paginaFinal" => "e46"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "La resonancia magn&#233;tica muscular y el tratamiento agresivo precoz&#44; claves en la dermatomiositis juvenil"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1849
              "Ancho" => 2500
              "Tamanyo" => 213748
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Magnetic resonance imaging &#40;MRI&#41; findings&#46; A&#44; Patient &#35;1&#46; Whole-body muscle MRI&#46; Increased intensity in STIR &#40;short tau inversion recovery&#41; sequence of buttock region and vastus lateralis&#44; consistent with muscle edema&#44; a sign of muscle inflammation&#46; Integration of this finding confirmed the diagnosis of juvenile dermatomyositis&#46; B&#44; Patient &#35;4&#46; MRI of shoulder muscle&#46; Increased signal from right deltoids and fascia in association with a small quantity of liquid in the subacromial bursa&#46; C&#44; patient &#35;5&#46; Whole-body muscle MRI after initiation of treatment&#46; Note the hypointense calcinosis cutis plaque in the right low lumbar region &#40;&#42;&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "O&#46; Corral-Maga&#241;a, A&#46;F&#46; Bauz&#225;-Alonso, M&#46;M&#46; Escudero-G&#243;ngora, L&#46; Lacruz, A&#46; Mart&#237;n-Santiago"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "O&#46;"
              "apellidos" => "Corral-Maga&#241;a"
            ]
            1 => array:2 [
              "nombre" => "A&#46;F&#46;"
              "apellidos" => "Bauz&#225;-Alonso"
            ]
            2 => array:2 [
              "nombre" => "M&#46;M&#46;"
              "apellidos" => "Escudero-G&#243;ngora"
            ]
            3 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Lacruz"
            ]
            4 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Mart&#237;n-Santiago"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731017303782"
        "doi" => "10.1016/j.ad.2017.07.003"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017303782?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018301720?idApp=UINPBA000044"
    "url" => "/15782190/0000010900000006/v1_201808010420/S1578219018301720/v1_201808010420/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case for Diagnosis</span>"
    "titulo" => "Erythematous Pedunculated Papule on the Knee"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "543"
        "paginaFinal" => "544"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "M&#46;C&#46; Garc&#237;a del Pozo, C&#46; Mart&#237;n de Hijas, L&#46; &#205;&#241;iguez de Onzo&#241;o"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "M&#46;C&#46;"
            "apellidos" => "Garc&#237;a del Pozo"
            "email" => array:1 [
              0 => "sakuragarciadelpozo&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Mart&#237;n de Hijas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "L&#46;"
            "apellidos" => "&#205;&#241;iguez de Onzo&#241;o"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a M&#233;dico-Quir&#250;rgica y Venereolog&#237;a&#44; Complejo Hospitalario Universitario de Albacete&#44; Albacete&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Anatom&#237;a Patol&#243;gica&#44; Complejo Hospitalario Universitario de Albacete&#44; Albacete&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "P&#225;pula eritematosa pediculada en la rodilla"
      ]
    ]
    "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" => 571
            "Ancho" => 750
            "Tamanyo" => 183266
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin-eosin&#44; original magnification &#215;10&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Medical History</span><p id="par0005" class="elsevierStylePara elsevierViewall">An 81-year-old man with a past history of type 2 diabetes mellitus&#44; hypertension&#44; hypercholesterolemia&#44; and chronic bronchitis presented with an asymptomatic lesion on the left popliteal fossa that had grown steadily in size since appearing 1 year earlier&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">Physical examination revealed a 6-mm-long erythematous pedunculated papule on the left popliteal fossa that was firm in consistency&#44; showed no erosion or ulceration&#44; and was not adherent to deeper tissues &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The patient had no palpable locoregional lymph nodes&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Histopathology</span><p id="par0015" class="elsevierStylePara elsevierViewall">Complete excision of the lesion was performed&#46; Pathologic examination revealed a nonencapsulated polypoid neoformation &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41; composed of dermal tumor nodules separated by fibrous tracts&#46; The nodules consisted of 2 types of cells&#58; round cells with clear cytoplasm showing a positive periodic acid-Schiff reaction &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41; and polyhedral cells with round nuclei and slightly basophilic cytoplasm&#46; No mitotic figures or angiolymphatic or perineural invasion were observed&#46; Also present were cysts containing homogeneous eosinophilic material&#44; surrounded by a layer of cuboidal epithelial cells&#44; with no evidence of decapitation secretion&#46;<span class="elsevierStyleVsp" style="height:0.5px"></span></p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">What Is Your Diagnosis&#63;</span></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Diagnosis</span><p id="par0025" class="elsevierStylePara elsevierViewall">Nodular hidradenoma&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Clinical Course</span><p id="par0030" class="elsevierStylePara elsevierViewall">Follow-up at 1 year showed no recurrence of the lesion&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Comment</span><p id="par0035" class="elsevierStylePara elsevierViewall">Nodular hidradenoma &#40;also known as apocrine hidradenoma&#44; clear cell hidradenoma&#44; solid-cystic hidradenoma&#44; eccrine acrospiroma&#44; and clear cell acrospiroma&#41; is a benign tumor&#46; The apocrine or eccrine differentiation of this entity has been the subject of debate&#46; Some authors have reported decapitation secretion&#44; which suggests an apocrine origin&#59; others have noted the absence of apocrine secretion and the existence of ultrastructural features of immature eccrine glands&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> This entity is more common in women and tends to appear between the fourth and sixth decades of life&#44; but cases in children have also been reported&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#44;3</span></a> The lesion tends to present as a single&#44; slow-growing&#44; skin-colored or erythematous-brownish nodule measuring less than 2-3<span class="elsevierStyleHsp" style=""></span>cm in diameter&#44; either firm in consistency or fluctuant if the cystic component is predominant&#46; The tumors are generally asymptomatic but erosion or ulceration can be present and&#44; in cystic lesions&#44; serous discharge can be present&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> Pedunculated lesions&#8212;like that of our patient&#8212;have been reported but are very rare&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> The lesion can appear on any part of the body&#44; although the head and neck&#44; trunk&#44; and upper limbs are the most common sites&#46; Dermoscopy shows homogeneous reddish&#44; bluish&#44; bluish-red&#44; or brown areas comprising all or part of the lesion&#44; whitish vascular structures such as arborizing telangiectasias&#44; and polymorphous atypical vessels&#44; making these lesions difficult to distinguish from basal cell carcinomas and melanomas&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> Immunohistochemical analysis shows positivity for anticytokeratin CAM 5&#46;2 in most tumors&#46; Carcinoembryonic antigen&#44; epithelial membrane antigen&#44; S-100 protein&#44; smooth muscle actin&#44; and vimentin are also expressed in some cases&#46; Staining with antibodies targeting various cytokeratin subtypes is variable in different parts of the tumor&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> However&#44; immunohistochemical analysis is not usually necessary because this entity can be diagnosed easily with conventional techniques such as hematoxylin-eosin staining&#46; Malignant transformation into hidradenocarcinoma is very rare and should be suspected when histologic examination reveals a pattern of infiltrative growth&#44; necrosis&#44; nuclear pleomorphism&#44; abundant mitotic figures&#44; and angiolymphatic or perineural invasion&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Surgical resection is curative&#59; however&#44; the rate of recurrence&#8212;due to incomplete resection&#8212;is approximately 10&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">In this article&#44; we describe a case of nodular hidradenoma with a rare pedunculated presentation&#46; This unusual variety of the lesion must be differentiated from entities of similar morphology&#44; such as fibroepithelioma of Pinkus&#44; fibrolipoma&#44; and angioma&#46; The histologic differential diagnosis includes other clear cell malignancies such as metastatic cancer &#40;usually of renal cell carcinoma&#41; and primary cutaneous tumors with follicular&#44; sebaceous&#44; and sweat gland differentiation&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflicts of Interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:8 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Medical History"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Physical Examination"
        ]
        2 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Histopathology"
        ]
        3 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Diagnosis"
        ]
        4 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Clinical Course"
        ]
        5 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Comment"
        ]
        6 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Conflicts of Interest"
        ]
        7 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Garc&#237;a del Pozo MC&#44; Mart&#237;n de Hijas C&#44; I&#241;&#237;guez L&#46; P&#225;pula eritematosa pediculada en la rodilla&#46; Actas Dermosifiliogr&#46; 2018&#59;109&#58;543&#8211;544&#46;</p>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:6 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 645
            "Ancho" => 750
            "Tamanyo" => 42048
          ]
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 879
            "Ancho" => 750
            "Tamanyo" => 201944
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Panoramic view &#40;hematoxylin-eosin&#41;&#46;</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" => 571
            "Ancho" => 750
            "Tamanyo" => 183266
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin-eosin&#44; original magnification &#215;10&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:6 [
            0 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What is your diagnosis&#63; Clear cell hidradenoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Egesi"
                            1 => "A&#46; Ingraffea"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cutis"
                        "fecha" => "2014"
                        "volumen" => "94"
                        "paginaInicial" => "271"
                        "paginaFinal" => "272"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A Weeping Tumor in a Young Girl&#58; An Unusual Presentation of Nodular Hidradenoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Das"
                            1 => "T&#46; Gayen"
                            2 => "I&#46; Podder"
                            3 => "K&#46; Shome"
                            4 => "D&#46; Bandyopadhyay"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4103/0019-5154.182423"
                      "Revista" => array:6 [
                        "tituloSerie" => "Indian J Dermatol"
                        "fecha" => "2016"
                        "volumen" => "61"
                        "paginaInicial" => "321"
                        "paginaFinal" => "323"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27293255"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clear cell hidradenoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46; Gilaberte"
                            1 => "M&#46;P&#46; Grasa"
                            2 => "F&#46;J&#46; Carapeto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2006.03.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2006"
                        "volumen" => "54"
                        "paginaInicial" => "248"
                        "paginaFinal" => "249"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16631962"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrent draining cyst on the shoulder&#58; Clear cell hidradenoma &#40;CCH&#41; &#40;nodular hidradenoma&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;T&#46; Hampton"
                            1 => "P&#46;E&#46; Sahn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1992"
                        "volumen" => "128"
                        "paginaInicial" => "1533"
                        "paginaFinal" => "1534"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermoscopy of Nodular Hidradenoma&#44; a Great Masquerader&#58; A Morphological Study of 28 Cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Serrano"
                            1 => "A&#46; Lallas"
                            2 => "L&#46;J&#46; del Pozo"
                            3 => "I&#46; Karaarslan"
                            4 => "C&#46; Medina"
                            5 => "L&#46; Thomas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000441218"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatology"
                        "fecha" => "2016"
                        "volumen" => "232"
                        "paginaInicial" => "78"
                        "paginaFinal" => "82"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26606241"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A study of histopathologic spectrum of nodular hidradenoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46;N&#46; Nandeesh"
                            1 => "T&#46; Rajalakshmi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/DAD.0b013e31821a4d33"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Dermatopathol"
                        "fecha" => "2012"
                        "volumen" => "34"
                        "paginaInicial" => "461"
                        "paginaFinal" => "470"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21993337"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010900000006/v1_201808010420/S1578219018301641/v1_201808010420/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6154"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Case for Diagnosis"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010900000006/v1_201808010420/S1578219018301641/v1_201808010420/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018301641?idApp=UINPBA000044"
]
Compartir
Información de la revista
Vol. 109. Núm. 6.
Páginas 543-544 (julio - agosto 2018)
Visitas
5838
Vol. 109. Núm. 6.
Páginas 543-544 (julio - agosto 2018)
Case for Diagnosis
Acceso a texto completo
Erythematous Pedunculated Papule on the Knee
Pápula eritematosa pediculada en la rodilla
Visitas
5838
M.C. García del Pozoa,
Autor para correspondencia
sakuragarciadelpozo@hotmail.com

Corresponding author.
, C. Martín de Hijasa, L. Íñiguez de Onzoñob
a Servicio de Dermatología Médico-Quirúrgica y Venereología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
b Servicio de Anatomía Patológica, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
Este artículo ha recibido
Información del artículo
Texto completo
Bibliografía
Descargar PDF
Estadísticas
Figuras (3)
Mostrar másMostrar menos
Texto completo
Medical History

An 81-year-old man with a past history of type 2 diabetes mellitus, hypertension, hypercholesterolemia, and chronic bronchitis presented with an asymptomatic lesion on the left popliteal fossa that had grown steadily in size since appearing 1 year earlier.

Physical Examination

Physical examination revealed a 6-mm-long erythematous pedunculated papule on the left popliteal fossa that was firm in consistency, showed no erosion or ulceration, and was not adherent to deeper tissues (Fig. 1). The patient had no palpable locoregional lymph nodes.

Figure 1
(0.04MB).
Histopathology

Complete excision of the lesion was performed. Pathologic examination revealed a nonencapsulated polypoid neoformation (Fig. 2) composed of dermal tumor nodules separated by fibrous tracts. The nodules consisted of 2 types of cells: round cells with clear cytoplasm showing a positive periodic acid-Schiff reaction (Fig. 3) and polyhedral cells with round nuclei and slightly basophilic cytoplasm. No mitotic figures or angiolymphatic or perineural invasion were observed. Also present were cysts containing homogeneous eosinophilic material, surrounded by a layer of cuboidal epithelial cells, with no evidence of decapitation secretion.

Figure 2.

Panoramic view (hematoxylin-eosin).

(0.19MB).
Figure 3.

Hematoxylin-eosin, original magnification ×10.

(0.17MB).

What Is Your Diagnosis?

Diagnosis

Nodular hidradenoma.

Clinical Course

Follow-up at 1 year showed no recurrence of the lesion.

Comment

Nodular hidradenoma (also known as apocrine hidradenoma, clear cell hidradenoma, solid-cystic hidradenoma, eccrine acrospiroma, and clear cell acrospiroma) is a benign tumor. The apocrine or eccrine differentiation of this entity has been the subject of debate. Some authors have reported decapitation secretion, which suggests an apocrine origin; others have noted the absence of apocrine secretion and the existence of ultrastructural features of immature eccrine glands.1 This entity is more common in women and tends to appear between the fourth and sixth decades of life, but cases in children have also been reported.2,3 The lesion tends to present as a single, slow-growing, skin-colored or erythematous-brownish nodule measuring less than 2-3cm in diameter, either firm in consistency or fluctuant if the cystic component is predominant. The tumors are generally asymptomatic but erosion or ulceration can be present and, in cystic lesions, serous discharge can be present.2 Pedunculated lesions—like that of our patient—have been reported but are very rare.4 The lesion can appear on any part of the body, although the head and neck, trunk, and upper limbs are the most common sites. Dermoscopy shows homogeneous reddish, bluish, bluish-red, or brown areas comprising all or part of the lesion, whitish vascular structures such as arborizing telangiectasias, and polymorphous atypical vessels, making these lesions difficult to distinguish from basal cell carcinomas and melanomas.5 Immunohistochemical analysis shows positivity for anticytokeratin CAM 5.2 in most tumors. Carcinoembryonic antigen, epithelial membrane antigen, S-100 protein, smooth muscle actin, and vimentin are also expressed in some cases. Staining with antibodies targeting various cytokeratin subtypes is variable in different parts of the tumor.2 However, immunohistochemical analysis is not usually necessary because this entity can be diagnosed easily with conventional techniques such as hematoxylin-eosin staining. Malignant transformation into hidradenocarcinoma is very rare and should be suspected when histologic examination reveals a pattern of infiltrative growth, necrosis, nuclear pleomorphism, abundant mitotic figures, and angiolymphatic or perineural invasion.6

Surgical resection is curative; however, the rate of recurrence—due to incomplete resection—is approximately 10%.2

In this article, we describe a case of nodular hidradenoma with a rare pedunculated presentation. This unusual variety of the lesion must be differentiated from entities of similar morphology, such as fibroepithelioma of Pinkus, fibrolipoma, and angioma. The histologic differential diagnosis includes other clear cell malignancies such as metastatic cancer (usually of renal cell carcinoma) and primary cutaneous tumors with follicular, sebaceous, and sweat gland differentiation.6

Conflicts of Interest

The authors declare that they have no conflicts of interest.

References
[1]
A. Egesi, A. Ingraffea.
What is your diagnosis? Clear cell hidradenoma.
Cutis, 94 (2014), pp. 271-272
[2]
A. Das, T. Gayen, I. Podder, K. Shome, D. Bandyopadhyay.
A Weeping Tumor in a Young Girl: An Unusual Presentation of Nodular Hidradenoma.
Indian J Dermatol, 61 (2016), pp. 321-323
[3]
Y. Gilaberte, M.P. Grasa, F.J. Carapeto.
Clear cell hidradenoma.
J Am Acad Dermatol, 54 (2006), pp. 248-249
[4]
M.T. Hampton, P.E. Sahn.
Recurrent draining cyst on the shoulder: Clear cell hidradenoma (CCH) (nodular hidradenoma).
Arch Dermatol, 128 (1992), pp. 1533-1534
[5]
P. Serrano, A. Lallas, L.J. del Pozo, I. Karaarslan, C. Medina, L. Thomas, et al.
Dermoscopy of Nodular Hidradenoma, a Great Masquerader: A Morphological Study of 28 Cases.
Dermatology, 232 (2016), pp. 78-82
[6]
B.N. Nandeesh, T. Rajalakshmi.
A study of histopathologic spectrum of nodular hidradenoma.
Am J Dermatopathol, 34 (2012), pp. 461-470

Please cite this article as: García del Pozo MC, Martín de Hijas C, Iñíguez L. Pápula eritematosa pediculada en la rodilla. Actas Dermosifiliogr. 2018;109:543–544.

Copyright © 2017. Elsevier España, S.L.U. and AEDV
Descargar PDF
Idiomas
Actas Dermo-Sifiliográficas
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?