Indian Dermatology Online Journal

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


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

Correspondence Address:
Krina B Patel
Department of Dermatology, GMERS Medical College and Hospital, Sola, Ahmedabad, Gujarat
India




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;6:306-307


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 2020 Nov 25 ];6:306-307
Available from: https://www.idoj.in/text.asp?2015/6/4/306/160299


Full Text

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}

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}

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

1Wang 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.
2Abell E, Read SI. Porokeratotic eccrine ostial and dermal duct naevus. Br J Dermatol 1980;103:435-41.
3Leung 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.
4Mazuecos 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.
5Happle R. What is a nevus? A proposed definition of a common medical term. Dermatology 1995;191:1-5.
6Del 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.
7Warren RB, Verbov JL, Kokai GK. Porokeratotic eccrine ostial and dermal duct nevus. Pediatr Dermatol 2006;23:465-6.
8Pathak D, Kubba R, Kubba A. Porokeratotic eccrine ostial and dermal duct nevus. Indian J Dermatol Venereol Leprol 2011;77:174-6.
9Dogra S, Jain R, Mohanty SK, Handa S. Porokeratotic eccrine ostial and dermal duct nevus: Unilateral systematized involvement. Pediatr Dermatol 2002;19:568-9.
10Kumar P, Mondal AK, Ghosh K, Mondal A, Gharami RC, Chowdhury SN. Multiple keratotic papules on palm. Dermatol Online J 2012;18:10.