Dermoscopy of eccrine angiomatous hamartoma: The spitzoid pattern

A 5-year old girl presented with an erythematous, asymptomatic nodule of the left knee, which appeared 1 year before (Fig 1). Dermoscopic examination found a spitzoid pattern, with brown globules, a background of erythema, and a pseudo-reticular depigmentation around the globules (Fig 2). The lesion was excised to rule out a spitzoid melanoma. Histologic examination found in the reticular dermis an increased number of eccrine glands and terminal hair follicles admixed with irregular, dilated blood structures and fat lobules (Fig 3). Pathologic features were consistent with the diagnosis of eccrine angiomatous hamartoma (EAH).Key messageEAH is a rare variety of hamartoma. EAH presents at birth or early childhood as a nonspecific red, brown, or yellow nodule or plaque. When symptomatic, EAH may be associated with hyperhidrosis or pain.1Sanusi T. Li Y. Sun L. Wang C. Zhou Y. Huang C. Eccrine angiomatous hamartoma: a clinicopathological study of 26 cases.Dermatology. 2015; 231: 63-69Crossref PubMed Scopus (10) Google Scholar The diagnosis is established by histopathology. Recently, the first dermoscopic description of EAH was reported as the popcorn pattern, consisting of multiple yellow, confluent nodules in a popcorn shape, over a background of erythema and linear and arborizing blood vessels.2García-García S.C. Saeb-Lima M. Villarreal-Martínez A. et al.Dermoscopy of eccrine angiomatous hamartoma: the popcorn pattern.JAAD Case Rep. 2018; 4: 165-167Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar Here we report a typical case of EAH, with a spitzoid dermoscopic pattern. The presence of brown globules in dermoscopy is usually indicative of a melanocytic lesion, but in this case it is possible that the globules reflected the numerous dilated eccrine glands. The dermoscopic aspect of EAH is heterogeneous and can be misleading. More cases are needed to describe the dermoscopic landscape of EAH. EAH is a rare variety of hamartoma. EAH presents at birth or early childhood as a nonspecific red, brown, or yellow nodule or plaque. When symptomatic, EAH may be associated with hyperhidrosis or pain.1Sanusi T. Li Y. Sun L. Wang C. Zhou Y. Huang C. Eccrine angiomatous hamartoma: a clinicopathological study of 26 cases.Dermatology. 2015; 231: 63-69Crossref PubMed Scopus (10) Google Scholar The diagnosis is established by histopathology. Recently, the first dermoscopic description of EAH was reported as the popcorn pattern, consisting of multiple yellow, confluent nodules in a popcorn shape, over a background of erythema and linear and arborizing blood vessels.2García-García S.C. Saeb-Lima M. Villarreal-Martínez A. et al.Dermoscopy of eccrine angiomatous hamartoma: the popcorn pattern.JAAD Case Rep. 2018; 4: 165-167Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar Here we report a typical case of EAH, with a spitzoid dermoscopic pattern. The presence of brown globules in dermoscopy is usually indicative of a melanocytic lesion, but in this case it is possible that the globules reflected the numerous dilated eccrine glands. The dermoscopic aspect of EAH is heterogeneous and can be misleading. More cases are needed to describe the dermoscopic landscape of EAH.