Navigating Head and Neck Porocarcinoma: Systematic Review with Special Emphasis on Surgical Safety Margins.

Eccrine porocarcinoma, sharing many features with other skin tumours, is diagnostically challenging. A conventional biopsy might be misleading and surgical excision becomes a primary diagnostic tool and a treatment method. However, the data on surgical safety margins are not consistent. We present a systematic review analysing the surgical margins of porocarcinoma in the head and neck area, which was conducted across the PubMed, Cochrane, and Web of Science databases including studies published from inception to November of 2023. In this systematic review, the PRISMA-ScR checklist was used, and a Cohen's Kappa coefficient of 0.92 was applied, indicating very good agreement between reviewers. Out of 529 identified articles, 18 studies yielding 20 cases in total were selected for a thorough analysis. Nine (45%) cases were observed in the facial regions, eight (40%) on the scalp, and three (5%) on the neck. The primary treatment of choice was wide local excision with safety margins ranging from 3 to 22 mm (mean: 10.1). It demonstrated that surgical margins do not differ by age or anatomic regions, with the main point of reference being the tumour size. As observed, the bigger the tumour, the wider the safety margins were. However, the limited disclosure of surgical safety margins in analysed case reports impeded our ability to define the minimum safety margins. Further investigation and a consensus on recommended safety margins are required.

Eccrine Poroma with Concurrent Basal Cell Carcinoma: A Rare Combination.

Eccrine poroma (EP) is a benign skin appendicular tumor that differentiates into the terminal sweat duct and is often differentiated from basal cell carcinoma (BCC) and seborrheic keratosis. This report describes a 58-year-old woman who presented with left occipital plaque. Histopathological analysis showed that the tumor cells were located in the lower part of the epidermis. The tumor cells were cuboidal or circular basal-like cells of the same size. The surrounding cells were not arranged in a palisade shape. Scattered tumor clusters composed of basal-like cells were also seen in the dermis, staining basophilic, and the surrounding cells were arranged in a palisade pattern. Immunohistochemistry showed that BerEP4, epithelial membrane antigen EMA, carcinoembryonic antigen CEA, Bcl-2, CD10, CK7 were positive, AR, PAS were negative. According to the pathological examination and immunohistochemical results, a case of eccrine poroma with concurrent basal cell carcinoma was diagnosed.

Porocarcinoma Concurrent with Psoriasis Vulgaris: The First Report.

Psoriasis is a common chronical inflammatory skin disease with a prevalence of 2%-4% worldwide. In contrast, porocarcinoma is a relatively rare cutaneous neoplasm and an associated localization of both lesions is rare. Here, we describe the first case of porocarcinoma in a patient with psoriasis. A 71-year-old Japanese man was referred to our clinic for evaluation of nodule within a keratotic plaque of 20-years history on his leg. Histopathological examination showed that the plaque revealed acanthosis with regular elongation of rete ridges, agranulosis and the presence of Munro microabscesses. In contrast, massive proliferation of atypical poroid cells and a few cuticular cells in the dermis were seen in the nodule. We speculated that it is likely the porocarcinoma was caused by the elevated risk of skin cancer due to chronic inflammatory process of psoriasis itself in our patient.

Eccrine Poroma: Pathogenesis, New Diagnostic Tools and Association with Porocarcinoma-A Review.

Eccrine poroma (EP) is a relatively rare benign adnexal neoplasm that usually affects elderly patients. Its pathogenesis is still under investigation, but recent gene studies have revealed gene fusions as key incidences resulting in oncogenetic pathways. It often presents as a solitary, firm papule, mostly asymptomatic, located on the soles or palms. Due to its clinical and dermoscopic variability, it is characterized as the great imitator. We performed a literature review, aiming to summarize current data on the pathogenetic mechanisms, new dermoscopic features, and novel diagnostic tools that may aid in early diagnosis and proper management of this rare adnexal tumor. Furthermore, we reviewed the possible pathogenetic associations between EP and its malignant counterpart, namely eccrine porocarcinoma. This systematic approach may aid in understanding the pathogenetic mechanisms and how to use novel histopathologic markers and imaging methods to overcome the diagnostic dilemma of this rare tumor.

The role of line-field confocal optical coherence tomography (LC-OCT) in the diagnosis of eccrine poroma: A case report.

Poroma is skin cancer that arises from the sweat gland cells. Its diagnosis could be difficult. Line-field optical coherence tomography (LC-OCT) is a novel imaging technique that has shown promise in the diagnosis and monitoring of various skin conditions. We report a case of poroma diagnosed by LC-OCT.

Cryotherapy for Eccrine Poroma: A Case Report.

Eccrine poroma (EP) is a benign adnexal tumor that is derived from acrosyringium, the intraepidermal eccrine duct of sweat glands. The standard treatment for eccrine poroma is complete excision. However, this case report highlights cryotherapy as one of the modalities in treating eccrine poroma. We present a case of a 33-year-old male patient who was a known case of generalized vitiligo since he was nine years old. During our skin checkup before starting him on phototherapy, we found a mass over the palmar aspect of the middle finger of the right hand that started to appear five years ago. The mass gradually increased in size, was painless, has no discharge, and was not associated with a history of trauma or infection. The review of systems was unremarkable. Skin examination revealed an asymptomatic, 2.0 × 1.5 cm-sized, solitary, collarette-encircled, dome-shaped, flesh-colored, non-pigmented, deep-red nodule protrusion from the palmar aspect of the middle finger of the right hand. Poroma was considered as the diagnosis, and a punch skin biopsy was performed to confirm the diagnosis and to roll out pyogenic granuloma, amelanotic melanoma, and porocarcinoma as differential diagnoses. A 3 mm punch skin biopsy was performed under local anesthesia and was found to be histologically consistent with eccrine poroma. Hence, cryosurgery was chosen based on histological favorable features. We used cryospray in a single session of 15 seconds in three applications, with five-second intervals in between (skin frosting recovery). Furthermore, the lesion was completely curative with a single session of cryotherapy. The patient followed up for one year without evidence of recurrence.

Poroma. Estudio retrospectivo de 80 pacientes en un hospital terciario / Poroma: A Retrospective Series of 80 Patients at a Tertiary Care Hospital

Introducción El poroma es un tumor anexial benigno exclusivo de la piel que tiene una predilección por la piel palmoplantar.Objetivo Analizar las características clínicas del poroma en nuestra población.Material y métodosEstudio retrospectivo de los pacientes con poroma diagnosticados entre 2002 y 2021. Se revisaron las historias clínicas para obtener los siguientes datos: edad, sexo, localización, número de lesiones, diámetro, tiempo de evolución, características clínicas de los tumores, diagnóstico clínico de sospecha, estado de los márgenes de resección, desarrollo de recidiva y tiempo de seguimiento. Las variables categóricas se compararon mediante la prueba exacta de Fisher. Las variables continuas se compararon mediante la prueba t de Student cuando se confirmó la normalidad de la distribución de datos. De lo contrario, se realizó la prueba U de Mann-Whitney. ResultadosSe incluyeron 80 pacientes con poroma (31 mujeres y 49 varones, con una edad mediana de 65,5 años y rango intercuartílico [RIC] 29 años). La mediana del tiempo medio de evolución fue de 12 meses, RIC 21 meses y la mediana del diámetro 8mm, RIC 7. Ningún paciente presentó lesiones múltiples. Las lesiones se localizaron en la cabeza y el cuello en 13 casos, en el tronco en 13, en las extremidades superiores en 11 y en las extremidades inferiores en 43. Veintitrés lesiones (28,8%) se localizaron en piel acral (palmas 5, plantas 18). La localización en el cuero cabelludo fue más frecuente en el sexo femenino (p=0,041). Las lesiones acrales fueron con mayor frecuencia eritematosas (p=0,014). Cinco pacientes presentaron recidiva local. Conclusiones Aunque los poromas son especialmente frecuentes en la piel acral, sobre todo de los pies, en la mayoría de pacientes se localizan en otras regiones anatómicas (71,3%). El aspecto clínico clásico de lesión exofítica eritematosa se observa con una mayor frecuencia en las lesiones acrales. (AU)

Background Poroma is a benign, exclusively cutaneous, adnexal tumor with a predilection for palmoplantar skin. Objective To analyze the clinical characteristics of poroma in our population.Material and methodsRetrospective study of patients diagnosed with poroma between 2002 and 2021. We conducted a chart review to record age; sex; number, location, and diameter of lesions; time since onset; clinical characteristics; suspected clinical diagnosis; resection margin status; recurrences; and follow-up duration. Categorical variables were compared using the Fisher exact test. Continuous variables were compared using the t test or the Mann-Whitney U test depending on whether they were normally or nonnormally distributed. Results We studied 80 patients (31 women and 49 men) with a median (interquartile range [IQR]) age of 65.5 (29) years. Median time since onset of poroma was 12 (21) months. Median lesion diameter was 8(7)mm, and none of the patients had multiple lesions. The lesions were located on the head and neck in 13 cases, the trunk in 13, the upper extremities in 11, and the lower extremities in 43. Twenty-three lesions (28.8%) were located at acral sites (5 on the palms and 18 on the soles). Women were more likely to have scalp lesions (P=.041). Acral lesions were more likely to be erythematous (P=.014). Five patients experienced local recurrence. Conclusions Although poromas are particularly common in acral locations (especially the feet), most of the lesions in our series (71.3%) were located elsewhere. Acral lesions were more likely to show the classic clinical features of erythema and exophytic growth. (AU)

[Translated article] Poroma: A Retrospective Series of 80 Patients at a Tertiary Care Hospital / Poroma. Estudio retrospectivo de 80 pacientes en un hospital terciario

Background Poroma is a benign, exclusively cutaneous, adnexal tumor with a predilection for palmoplantar skin. Objective To analyze the clinical characteristics of poroma in our population.Material and methods Retrospective study of patients diagnosed with poroma between 2002 and 2021. We conducted a chart review to record age; sex; number, location, and diameter of lesions; time since onset; clinical characteristics; suspected clinical diagnosis; resection margin status; recurrences; and follow-up duration. Categorical variables were compared using the Fisher exact test. Continuous variables were compared using the t test or the Mann–Whitney U test depending on whether they were normally or nonnormally distributed. Results We studied 80 patients (31 women and 49 men) with a median (interquartile range [IQR]) age of 65.5 (29) years. Median time since onset of poroma was 12 (21) months. Median lesion diameter was 8 (7)mm, and none of the patients had multiple lesions. The lesions were located on the head and neck in 13 cases, the trunk in 13, the upper extremities in 11, and the lower extremities in 43. Twenty-three lesions (28.8%) were located at acral sites (5 on the palms and 18 on the soles). Women were more likely to have scalp lesions (P=.041). Acral lesions were more likely to be erythematous (P=.014). Five patients experienced local recurrence. Conclusions Although poromas are particularly common in acral locations (especially the feet), most of the lesions in our series (71.3%) were located elsewhere. Acral lesions were more likely to show the classic clinical features of erythema and exophytic growth. (AU)

Introducción El poroma es un tumor anexial benigno exclusivo de la piel que tiene predilección por la piel palmoplantar. Objetivo Analizar las características clínicas del poroma en nuestra población. Material y métodos Estudio retrospectivo de los pacientes con poroma diagnosticados entre 2002 y 2021. Se revisaron las historias clínicas para obtener los siguientes datos: edad, sexo, localización, número de lesiones, diámetro, tiempo de evolución, características clínicas de los tumores, diagnóstico clínico de sospecha, estado de los márgenes de resección, desarrollo de recidiva y tiempo de seguimiento. Las variables categóricas se compararon mediante la prueba exacta de Fisher. Las variables continuas se compararon mediante la prueba t de Student cuando se confirmó la normalidad de la distribución de datos. De lo contrario, se realizó la prueba U de Mann-Whitney. Resultados Se incluyeron 80 pacientes con poroma (31 mujeres y 49 varones, con una edad mediana de 65,5años y rango intercuartílico [RIC] de 29 años). La mediana del tiempo medio de evolución fue de 12meses, RIC 21 meses, y la mediana del diámetro 8mm, RIC 7. Ningún paciente presentó lesiones múltiples. Las lesiones se localizaron en la cabeza y en el cuello en 13 casos, en el tronco en 13, en las extremidades superiores en 11 y en las extremidades inferiores en 43. Veintitrés lesiones (28,8%) se localizaron en piel acral (palmas 5, plantas 18). La localización en el cuero cabelludo fue más frecuente en el sexo femenino (p=0,041). Las lesiones acrales fueron con mayor frecuencia eritematosas (p=0,014). Cinco pacientes presentaron recidiva local. Conclusiones Aunque los poromas son especialmente frecuentes en la piel acral, sobre todo de los pies, en la mayoría de pacientes se localizan en otras regiones anatómicas (71,3%). El aspecto clínico clásico de lesión exofítica eritematosa se observa con una mayor frecuencia en las lesiones acrales. (AU)

Poroma: A Retrospective Series of 80 Patients at a Tertiary Care Hospital. / Poroma. Estudio retrospectivo de 80 pacientes en un hospital terciario.

BACKGROUND: Poroma is a benign, exclusively cutaneous, adnexal tumor with a predilection for palmoplantar skin. OBJECTIVE: To analyze the clinical characteristics of poroma in our population. MATERIAL AND METHODS: Retrospective study of patients diagnosed with poroma between 2002 and 2021. We conducted a chart review to record age; sex; number, location, and diameter of lesions; time since onset; clinical characteristics; suspected clinical diagnosis; resection margin status; recurrences; and follow-up duration. Categorical variables were compared using the Fisher exact test. Continuous variables were compared using the t test or the Mann-Whitney U test depending on whether they were normally or nonnormally distributed. RESULTS: We studied 80 patients (31 women and 49 men) with a median (interquartile range [IQR]) age of 65.5 (29) years. Median time since onset of poroma was 12 (21) months. Median lesion diameter was 8(7)mm, and none of the patients had multiple lesions. The lesions were located on the head and neck in 13 cases, the trunk in 13, the upper extremities in 11, and the lower extremities in 43. Twenty-three lesions (28.8%) were located at acral sites (5 on the palms and 18 on the soles). Women were more likely to have scalp lesions (P=.041). Acral lesions were more likely to be erythematous (P=.014). Five patients experienced local recurrence. CONCLUSIONS: Although poromas are particularly common in acral locations (especially the feet), most of the lesions in our series (71.3%) were located elsewhere. Acral lesions were more likely to show the classic clinical features of erythema and exophytic growth.

Eccrine poroma localized in the second toe.

Eccrine poroma is a rare adult benign adnexal tumor that originates in the excretory pore of the sweat gland. It is a small reddish lesion, protuberant, fleshy, and well-defined. It is located preferably in the palms of the hands and the soles of the feet [1]. Nevertheless, it may be found on any skin part of the body's surface [2]. We report a case of eccrine poroma of relatively rare localization on the second toe of the left foot. The biopsy confirmed the diagnosis by objectifying the histological lesions corresponding with the poroma. The article aims to report an eccrine poroma located in an unusual location, surgical treatment, and follow-up.

Rare case of large eccrine poroma of the eyelid.

Eccrine poroma is a rare tumor arising from sweat glands with common location being soles and palms. We are reporting a case of 70-year male patient with large lower lid mass lesion. Owing to its location and history of growth, malignancy was suspected. Biopsy proved it to be eccrine poroma which is a benign lesion. Complete excision with lid reconstruction was done. Eccrine poroma, though rare, should be kept in the differential diagnosis of eyelid tumors. Owing to the risk of malignant transformation and difficulty in clinical differentiation between poroma and porocarcinoma, wide excision should be done.

Diagnostic features of a non-pigmented eccrine poroma with a collarette: Histopathological and dermoscopic correlation.

This is a case that emphasized the need for detailed observation of the entire lesion in dermoscopic examination. Novel dermoscopic findings within a collarette.

Metastatic Porocarcinoma Effectively Managed by Pembrolizumab.

Eccrine porocarcinoma (EPC) is a rare malignancy of the sweat glands. Currently, there is no standard algorithm for its presentations, diagnosis, and management. However, immunotherapy is an emerging option that may be crucial to the treatment of EPC. This report presents a case of a 79-year-old male who had a skin biopsy of an anterior scalp lesion, which revealed EPC. The patient underwent Mohs micrographic surgery to excise the tumor followed by two additional Mohs surgeries for recurrence and adjuvant radiotherapy. A follow-up positron emission tomography (PET) scan revealed yet another recurrence at the scalp as well as metastases to the left parotid gland and left submandibular lymph node. The patient was started on immunotherapy with pembrolizumab, a programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitor, and later achieved remission. This report demonstrates the effective management of EPC using immunotherapy with pembrolizumab.

A Growing Mass under the Nail: Subungual Eccrine Poroma.

Eccrine poroma is a benign adnexal tumour, which originates from the acrosyringium of eccrine sweat glands. Eccrine poroma is an uncommon neoplasm, the typical clinical presentation of which is a solitary soft sessile reddish papule protruding from a cup-shaped shallow depression. Many challenges remain in the diagnosis of eccrine poroma because it does not always present with classical features and may mimic any other cutaneous benign and malignant lesions. Eccrine poromas may occur on any skin surface with sweat glands; on the other hand, the most common sites of involvement include the palms and soles, which are rich in eccrine sweat glands. Here, we present a case of subungual eccrine poroma, which is an extremely rare presentation of poromas. We also highlight dermoscopic features of eccrine poroma and review the available literature on the subject.

A rare case of recurrent eccrine poroma underlying gluteal abscess.

INTRODUCTION: Eccrine poroma is a benign adnexal neoplasm originating from epidermal sweat ducts mainly affecting the palmoplantar skin, buttock as a location of origin of poroma has rarely been reported, it is the first reported case of recurrent poroma in this site. PRESENTATION OF CASE: We report an unusual case of eccrine poroma in the gluteal region of a 62 years old female associated with gluteal abscess, surgically excised with histologically clear margins, then recurred after one and half year with a given history of mild trauma. DISCUSSION: Given the uncommonness of these neoplasms, there stays a general lack of data on pathogenesis, atypical presentation, atypical sites, recurrence and risk of malignant transformation into porocarcinoma. CONCLUSION: Gluteal skin is an unusual location for a benign poroma. Early recognition and appropriate treatment at the initial presentation by complete resection with histopathology confirmation and follow-up are crucial to ruling out other diagnoses, such as lesions of malignant transformation.