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THROUGH THE LENS
Year : 2015  |  Volume : 6  |  Issue : 4  |  Page : 306-307  

Porokeratotic eccrine ostial and dermal duct nevus: Case report of a rare entity


Department of Dermatology, GMERS Medical College and Hospital, Sola, Ahmedabad, Gujarat, India

Date of Web Publication8-Jul-2015

Correspondence Address:
Krina B Patel
Department of Dermatology, GMERS Medical College and Hospital, Sola, Ahmedabad, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.160299

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How to cite this article:
Patel KB. Porokeratotic eccrine ostial and dermal duct nevus: Case report of a rare entity. Indian Dermatol Online J 2015;6:306-7

How to cite this URL:
Patel KB. Porokeratotic eccrine ostial and dermal duct nevus: Case report of a rare entity. Indian Dermatol Online J [serial online] 2015 [cited 2019 Dec 7];6:306-7. Available from: http://www.idoj.in/text.asp?2015/6/4/306/160299

A 47-year-old male patient presented with itchy skin lesions over his left foot. On examination, patient had multiple, grouped but discrete, pinhead to 0.5 mm sized, crusted, folliculopapular and comedone-like lesions over the left foot. Lesions were keratotic in feel, had crater-like margins and were arranged in a linear fashion on the left foot starting from dorsum of 3 rd toe, margin of 4 th toe, sole, lateral aspect and dorsum of the foot, extending up to the posterior aspect of the heel [Figure 1]a-c]. Lesions were present since birth and patient had no complaints except occasional mild pruritus.
Figure 1: (a-c) Discrete, keratotic lesions on sole, toes and heel of foot in a linear distribution

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Histopathology from the lesion on the side of the foot showed variable hyperkeratosis, acanthosis with parakeratotic invaginations in the epidermis. Dermis showed mature eccrine sweat glands in the mid and lower dermis underlying the porokeratotic column [Figure 2]a and b]. Histopathological changes confirmed the clinical diagnosis of porokeratotic eccrine ostial and dermal duct nevus (PEODDN).
Figure 2: (a) Parakeratotic column with underlying eccrine sweat glands on histopathology (H and E, ×100). (b) Close-up view of parakeratotic column (H and E, ×400)

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Porokeratotic eccrine ostial and dermal duct nevus is a rare congenital hamartoma with eccrine differentiation. Lesions of PEODDN present since birth or may appear during childhood or puberty. They are clinically characterized by asymptomatic, small, scaly, discrete, papules filled with keratin plugs resembling comedones arranged in a linear fashion on palms and/or soles. [1] The flexural aspect of hands and feet, and even trunk may be involved along lines of Blaschko. Extensive generalized involvement, either unilateral or systematized has also been described. [2],[3],[4] The lesions appear as comedones but at sites where there are no pilosebaceous follicles. The disorder is nonhereditary and may represent a genetic mosaicism. [5] PEODDN is histologically characterized by well-formed coronoid lamellae occurring in close proximity to underlying dilated eccrine ducts and acrosyringia. [6] A variety of therapies have been utilized to eradicate the lesions of PEODDN including topical keratolytic agents, systemic and topical retinoids, CO 2 laser therapy etc. [6],[7]

Our case of PEODDN is reported as the entity itself is very rare and very few cases have been reported in the literature till date, with only three cases from India. [8],[9],[10]



 
   References Top

1.
Wang NS, Meola T, Orlow SJ, Kamino H. Porokeratotic eccrine ostial and dermal duct nevus: A report of 2 cases and review of the literature. Am J Dermatopathol 2009;31:582-6.  Back to cited text no. 1
    
2.
Abell E, Read SI. Porokeratotic eccrine ostial and dermal duct naevus. Br J Dermatol 1980;103:435-41.  Back to cited text no. 2
    
3.
Leung CS, Tang WY, Lam WY, Fung WK, Lo KK. Porokeratotic eccrine ostial and dermal duct naevus with dermatomal trunk involvement: Literature review and report on the efficacy of laser treatment. Br J Dermatol 1998;138:684-8.  Back to cited text no. 3
    
4.
Mazuecos J, Ortega M, Ríos JJ, Camacho F. Long-term involution of unilateral porokeratotic eccrine ostial and dermal duct naevus. Acta Derm Venereol 2003;83:147-9.  Back to cited text no. 4
    
5.
Happle R. What is a nevus? A proposed definition of a common medical term. Dermatology 1995;191:1-5.  Back to cited text no. 5
    
6.
Del Pozo J, Martínez W, Verea MM, Yebra-Pimentel MT, García-Silva J, Fonseca E. Porokeratotic eccrine ostial and dermal duct naevus: Treatment with carbon dioxide laser. Br J Dermatol 1999;141:1144-5.  Back to cited text no. 6
    
7.
Warren RB, Verbov JL, Kokai GK. Porokeratotic eccrine ostial and dermal duct nevus. Pediatr Dermatol 2006;23:465-6.  Back to cited text no. 7
    
8.
Pathak D, Kubba R, Kubba A. Porokeratotic eccrine ostial and dermal duct nevus. Indian J Dermatol Venereol Leprol 2011;77:174-6.  Back to cited text no. 8
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9.
Dogra S, Jain R, Mohanty SK, Handa S. Porokeratotic eccrine ostial and dermal duct nevus: Unilateral systematized involvement. Pediatr Dermatol 2002;19:568-9.  Back to cited text no. 9
    
10.
Kumar P, Mondal AK, Ghosh K, Mondal A, Gharami RC, Chowdhury SN. Multiple keratotic papules on palm. Dermatol Online J 2012;18:10.  Back to cited text no. 10
    


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