Scalp porocarcinoma and lichen planopilaris.

Porocarcinoma (PC) is a malignant neoplasm arising from the intraepidermal ductal portion of the sweat gland duct. Lichen planopilaris (LPP) is a not so rare variant of cutaneous lichen planus (LP) with a preferential involvement of hair follicles, consisting of a chronic lymphocytic inflammation, leading to cicatricial alopecia. A 42-year-old woman, recently diagnosed with HIV infection, was referred to our clinic because of an alopecic patch of 6 years' duration. In the upper region of the alopecia a 1.5cm nodule was noticed, which the patient stated had started growing soon after the appearance of the hair loss. Biopsy of the alopecia margin confirmed the diagnosis of LPP, whereas biopsy of the nodule revealed an infiltrating tumor consistent with the diagnosis of PC. We present a scalp PC emerging in a background of LPP in an HIV patient. We do not know the role, if any, HIV infection and LPP played in this particular case. Immunosuppression and HIV have been implicated in the etiology of PC. However, her HIV diagnosis was made after the appearance of the scalp nodule. We did not find any association between LPP and PC in the literature. Even though an association by chance cannot be excluded, this deserves further investigation.

Porocarcinoma: ¿infrecuente o infradiagnosticado? Estudio retrospectivo de 6 casos y revisión bibliográfica / Porocarcinoma: Uncommon or underdiagnosed? A retrospective study of 6 cases and a review of the literature

El porocarcinoma es un tumor maligno infrecuente, habitualmente originado sobre un poroma de larga evolución. Normalmente se localiza en extremidades inferiores, cabeza y cuello, en la sexta y séptima décadas de la vida. Debido a la escasa cantidad de casos documentados, realizamos un estudio retrospectivo durante 12 años consecutivos entre los diagnósticos registrados en la base de datos de nuestro Servicio de Anatomía Patológica. Recogimos 6 casos de dicho tumor sobre un total de unas 33.000 biopsias de piel, y analizamos sus características clínicas e histopatológicas. Observamos una incidencia 4 veces superior a la descrita en otros estudios, predominio en mujeres, y una media de edad y tamaño tumoral superiores. Su presentación clínica variada, larga evolución asintomática, y sus características arquitecturales, citológicas e inmunohistoquímicas, sí son concordantes con la literatura previa (AU)

Porocarcinoma is a rare malignant sweat gland tumour, usually developing from a long standing poroma. It is frequently found on the lower extremities or head and neck, and most cases occur in elderly patients. Due to the limited infrequency of documented cases, we performed a retrospective study over 12 consecutive years from the database of our department of pathology. We collected 6 cases of this tumour from a total of 33,000 skin biopsies and reviewed the main clinical and histopathological findings. In comparison to previous studies, we found a 4-times-higher incidence of porocarcinoma, female predominance, a higher average age and a larger tumour size. However, their diverse clinical presentation, longstanding asymptomatic evolution, morphological features and immunohistochemical profile are consistent with previous literature (AU)

Espiradenoma ecrino maligno en el surco nasolabial. Caso clínico / Malignant eccrine spiradenoma of the nasolabial fold. A case report

El espiradenoma ecrino maligno (EEM) es un tumor maligno poco frecuente de las glándulas sudoríparas ecrinas. Suele presentarse como un pequeño nódulo eritematoso, firme, solitario y doloroso. La cabeza y el cuello son una localización excepcional. Se desconoce la etiología aunque se considera que un traumatismo previo es un factor implicado. El EEM se origina sobre un espiradenoma benigno previo. La conducta clínica es agresiva con una elevada tasa de recidivas y metástasis a distancia. El pronóstico es infausto. El diagnóstico se basa en los hallazgos histológicos y el tratamiento ha de ser agresivo desde el principio para obtener los mejores resultados. Desde que, en 1956, Kersting y Helwig describieran el primer caso, y, en 1971, Beekley y cols. documentaran su transformación maligna, sólo se han publicado unos pocos casos. En función de estas características específicas, describimos a un hombre de 75 años de edad, en el que se estableció el diagnóstico de este tumor, originado en una localización poco habitual, con una histopatología y conducta peculiares(AU)

Malignant eccrine spiradenoma (MES) is a rare malignancy of the eccrine sweat glands. It usually presents as a small, firm, reddish painful and small solitary nodule. Head and neck are rare locations. Etiology is unknown although previous trauma is believed to be an implicated factor. MES arises over a prior benign spiradenoma. Clinical behavior is aggressive with a high rate of recurrences and distant metastases. Prognosis is poor. Diagnosis is based on histological findings and treatment must be aggressive from the beginning to achieve the best results. Since Kersting and Helwig first described the case in 1956, and Beekley et al., reported its malignant transformation in 1971, only a few cases can be found in the literature. Based on these particular features we report a case of a 75-year-old man diagnosed on a MES that arises in a very unusual location, with a peculiar histopathology and behavior(AU)

Eccrine porocarcinoma with carcinomatous lymphangitis in a patient with history of arsenic exposure: a case report.

Eccrine porocarcinoma is a potentially fatal form of sweat gland carcinoma, due to its propensity to metastasize through lymph vessels. The authors report the case of a 69-year-old female who presented with swelling of the right leg and an ulcerated lesion of the right great toe. The initial histologic diagnosis was invasive squamous cell carcinoma. On follow-up, the patient developed lymphangitic tumor spread in the right leg, associated with right inguinal lymphadenopathy and lesions in vulva and flank. Reevaluation of the toe lesion led to a revised diagnosis of eccrine porocarcinoma. The patient also had 2 basal cell carcinomas of the multicentric/superficial type in the skin overlying the left breast. Past history included chronic ingestion of liquore arsenic (Fowler's solution) in early adulthood as treatment for dermatitis herpetiformis.