Sweat Protects against Contact Hypersensitivity: Transient Sweat Suppression Compromises Skin Barrier Function in Mice.

Although subtle barrier defects may facilitate allergen penetration, thereby enabling allergic sensitization, the relationship between sweating disturbance and skin barrier function is unknown. However, many studies on contact hypersensitivity in mice examined ear skin, which does not sweat, instead of the footpad, where sweating is uniquely present. In this study, we assessed whether sweat suppression in the footpad before hapten application provoked a skin barrier abnormality and reduced inflammatory thresholds to topical haptens. Mice without any genetic skin barrier dysfunction displayed markedly reduced inflammatory thresholds to haptens under transient sweat suppression before hapten application. Epicutaneously applied haptens penetrated the skin more robustly in the presence of sweat suppression compared with that in its absence, although this increase was abolished by exposure to high-humidity conditions. These mice displayed a subtle atopic dermatitis-like inflammation mediated by type 2 response-dominant inflammation and increased IgE responses, mimicking some events occurring in nonlesional atopic dermatitis skin in humans and in murine models. These lesions were dramatically attenuated by exposure to high-humidity conditions. In our model, hapten sensitization does not require mechanical injury, explaining why sensitization occurs through nonlesional atopic dermatitis skin. Awareness of the importance of preserving sweating responses is essential to prevent occupational contact dermatitis and atopic dermatitis.

Eccrine Hidradenoma of the Nasal Vestibule: A Rare Clinical Entity.

Eccrine hidradenoma is a relatively rare benign tumor of sweat gland origin but with possible malignant transformation. It usually consists of solitary, well-demarcated papules or nodules covered with normal skin. Common sites of involvement are the scalp, face, limbs, and anterior trunk. Although the lining of the nasal vestibule includes hair follicles, sebaceous glands, and sweat glands, an eccrine hidradenoma originating in the nasal vestibule has yet to be reported. Herein, we describe a rare clinical presentation of nasal eccrine hidradenoma, treated successfully using a transnasal endoscopic approach.

Organ transplant status, anatomic location, and age impact rates of adnexal involvement of actinic keratoses.

Actinic keratoses (AKs) are pre-malignant skin lesions that can give rise to squamous cell carcinomas. Involvement of adnexal structures by AKs has been postulated to confer resistance to therapy and facilitate malignant progression. In our study, we identified several factors associated with increased risk of adnexal involvement of AKs. We found an increased risk of follicular involvement in AKs on the head and neck, a slightly increased risk of eccrine involvement with increasing age, and an increased risk of eccrine involvement in organ transplant patients. Additionally, our data showed a higher overall rate of follicular involvement of AKs than previously reported.

Complex sweat gland hamartoma: A case report.

Syringocystadenoma papilliferum (SCAP), tubular apocrine adenoma (TAA), and eccrine nevus are rare benign sweat gland tumors with varied clinical presentations but generally distinctive histomorphologic profiles. TAA and SCAP have been associated with other cutaneous hamartomas, most commonly with nevus sebaceus. Additionally, TAA and SCAP have uncommonly co-occurred in the same lesion. In contrast to nevus sebaceus, eccrine nevus is considerably less common and is rarely associated with other benign adnexal lesions. Here we present an unusual case of a complex sweat gland hamartoma containing features of syringocystadenoma papilliferum, tubular apocrine adenoma, and eccrine nevus in a 7-year-old female.

Siringofibroadenoma écrino em paciente tetraplégico por mielite transversa / Eccrine syringofibroadenoma in a patient with quadriplegia following transverse myelitis

O siringofibroadenoma écrino (SFAE) é um tumor benigno raro que se origina das glândulas sudoríparas écrinas. Apresenta predileção pelas extremidades de indivíduos idosos e pode surgir em associação com várias doenças adquiridas ou hereditárias e com afecções cutâneas neoplásicas. Relatamos caso de homem de 48 anos, tetraplégico por mielite transversa há 30 anos, com tumoração plantar rapidamente progressiva de difícil diagnóstico

Eccrine syringofibroadenoma (EFAS) is a rare benign tumor that originates from the eccrine sweat glands. It has a predilection for the extremities of elderly individuals and may arise in association with various acquired or hereditary pathologies and neoplastic skin disorders. We report the case of a 48-year-old man who had been quadriplegic due to transverse myelitis for 30 years, with a rapidly progressive plantar tumor that was difficult to diagnose.

Intravascular Papillary Endothelial Hyperplasia in Association with Eccrine Angiokeratomatous Hamartoma.

Eccrine angiokeratomatous hamartoma is a variant of eccrine angiomatous hamartoma. Histopathologically, it shows both features of eccrine angiomatous hamartoma with components of angiokeratoma. Eccrine angiokeratomatous hamartoma is extremely rare. Eccrine angiokeratomatous hamartoma in our case co-existed with intravascular papillary endothelial hyperplasia. This is the first reported case.

Efficacy of Triamcinolone Acetonide Injection in a Case of Giant Spiradenoma.

Spiradenoma is a rare benign adnexal tumor with eccrine differentiation. The clinical manifestations include painful, skin-colored, red, gray, or bluish nodules on the upper half of the body. We report a case of spiradenoma in a 31-year-old man. The diagnosis was established from the patient's history, physical examination, and histopathological examination. In this case, the patient was treated with intralesional injection of triamcinolone acetonide (TA) 10 mg/mL. After the fourth injection, the lesions grew smaller and thinner. TA injection is easy to administer and showed good efficacy in spiradenoma case, although further research with a larger number of patients is needed.

Eccrine Angiomatous Hamartoma With Arteriovenous Malformation: A Rare Entity Re-Explored.

Eccrine angiomatous hamartoma (EAH) is a rare, benign, slow-growing cutaneous lesion characterized by hamartomatous proliferation of the eccrine glands and vascular structures. It usually arises in early childhood; however, cases in adults have also been reported. It is diagnosed based on the clinical features of the lesion as well as the histopathological findings of the excised tissue. As the name indicates, EAH shows a close association with mature eccrine elements and capillary-sized blood vessels at the histopathological level. In rare instances, the vascular component can show the features of arteriovenous malformations. Here, we report a rare case of EAH with a component of arteriovenous malformation in a 39-year-old woman who presented with a foot lesion.

A Case of Adult-Onset Eccrine Angiomatous Hamartoma-The Comparison with Epithelioid Hemangioma.

Eccrine angiomatous hamartoma (EAH) is a relatively rare benign skin disease characterized by the proliferation of eccrine sweat glands associated with capillary hemangioma and the proliferation of other skin elements such as adipose tissue, hair, and epidermis. The onset of the disease is usually at birth or in childhood and tends to occur in the extremities of females, but it occurred in an adult male in this case. The patient was a 72-year-old man with a 12 × 12 mm light brown, elastic, slightly firm skin nodule on the flexor aspect of his right forearm. A biopsy revealed enlargement of blood vessels, sweat glands, sweat ducts, and erector spongiosum with both lumen dilation and narrowing, leading to the diagnosis of EAH. The histopathological features of EAH include a marked proliferation of microvessels, epithelial-like changes in vascular endothelial cells (such as enlarged nuclei), and infiltration of inflammatory cells, mainly lymphocytes and plasma cells. In adult-onset cases, EAH can be clinically difficult to distinguish from epithelioid hemangioma (EH), which differs in the predominance of microvascular proliferation and the presence of eosinophils in the infiltrating inflammatory cells. It can also be distinguished from EAH by the negative results of S100 and anti-EMA in immunohistological staining. In the current cases, we were able to differentiate the two cases from characteristic findings on HE staining.

Tratamento de siringomas periorbitários: revisão da literatura científica nos últimos 5 anos / Treatment of periorbital syringomas: review of scientific literature in the last 5 years

Introdução: O siringomas são tumores anexais benignos com caraterísticas histopatológicas decorrentes dos ductos écrinos, em forma de pápulas amareladas ou cor da pele, de 1-3 mm, comumente na região periorbitária inferior, podendo causar problemas cosméticos importantes. O objetivo do tratamento é melhorar a aparência, através da destruição completa do tumor usando métodos minimamente invasivos e inclusa cirurgia. Existem na literatura múltiplas opções de tratamento com vários graus de sucesso, porém pouco se conhece sobre a eficácia. Em geral, a remoção completa não é bem-sucedida, e têm sido descritos efeitos colaterais, sendo a recorrência o mais frequente. Métodos: Trata-se de uma revisão narrativa de literatura, de publicações científicas no período de 2014-2019. Resultados: Após revisar 45 artigos, e identificar os publicados nos últimos cinco anos que tiveram registro de número de pacientes, descrição de tratamento, escalas de avaliação dos resultados e acompanhamento, foram selecionados seis artigos. Do número total de seis artigos, foram encontrados: uma revisão sistemática, e cinco estudos retrospectivos, sendo um comparativo. Foi designado um número para cada artigo analisado, e coletados o número de pacientes incluídos, tratamento realizado, escalas de avaliação e resultados, complicações e conclusões. Conclusões: Os siringomas periorbitários ainda são um desafio terapêutico, e até agora nenhum tratamento demostrou ser consistentemente eficaz. O laser CO2 continua sendo a primeira escolha de tratamento quando usado fracionado, e a eletrocoagulação intralesional representa uma segunda alternativa com resultados moderados e menor risco de complicações. Novos tratamentos como Laser Erbium Laser Erbium Yttrium Aluminum Garnet, Neodymium-Doped Yttrium Aluminum Garnet e monoterapia com toxina botulínica A poderiam ser boas alternativas. Estudos prospetivos comparativos são necessários.

Introduction: Syringomas are benign adnexal tumors with histopathological characteristics arising from the eccrine ducts, in yellowish or skin-colored papules, 1-3 mm, commonly in the lower periorbital region, which can cause important cosmetic problems. The goal of treatment is to improve appearance by destroying the tumor using minimally invasive methods and including surgery. There are multiple treatment options in the literature with varying degrees of success, but little is known about their effectiveness. Complete removal is unsuccessful, and side effects have been described, recurrence being the most frequent. Methods: This is a narrative review of the literature of scientific publications in the period 2014-2019. Results: After reviewing 45 articles and identifying those published in the last five years that had a record of the number of patients, treatment description, scales of evaluation of results and follow-up, six articles were selected. Of the total number of six articles, we found: a systematic review and five retrospective studies, one being a comparative one. A number was assigned to each article analyzed, and the number of patients included, treatment performed, assessment scales and results, complications and conclusions were collected. Conclusions: Periorbital syringomas are still a therapeutic challenge, and so far, no treatment is consistently effective. The CO2 laser remains the first choice of treatment when used fractionally, and intralesional electrocoagulation represents a second alternative with moderate results and a lower risk of complications. New treatments such as Laser Erbium Laser Erbium Yttrium Aluminum Garnet, Neodymium-Doped Yttrium Aluminum Garnet and botulinum toxin A monotherapy could be good alternatives. Comparative prospective studies are needed.

Siringoma condroide: apresentação incomum de tumor raro / Chondroid syringoma: unusual presentation of a rare tumor

O siringoma condroide, também conhecido como tumor misto cutâneo, é uma neoplasia benigna rara, originada das glândulas sudoríparas, composta por estruturas epiteliais imersas em um estroma mixocondroide. Geralmente, apresenta-se como tumor sólido, único, localizado em face ou pescoço, com evolução crônica e assintomática. Relata-se caso de mulher, 75 anos, com lesão discretamente elevada na fronte, cujo diagnóstico foi definido pela análise histopatológica.

Chondroid syringoma, also known as a cutaneous mixed tumor, is a rare benign neoplasm originating from the sweat glands, composed of epithelial structures immersed in a myxochondroid stroma. It usually presents as a solid, single tumor located on the face or neck with a chronic and asymptomatic course. We report the case of a 75-year-old woman with a slightly elevated lesion on the forehead, whose diagnosis was defined by histopathological analysis.

Eccrine Nevus in the Forearm of a 16-Year-Old Presenting as Unilateral Hyperhidrosis: A Clinicopathological Correlation Paradigm.

A case of a purely eccrine nevus in an adolescent patient presenting with focal hyperhidrosis on an area comprising the left forearm and the dorsal aspect of the left hand is described. No clinically evident lesions were identifiable. Dermatopathologic findings were subtle, showing only a slight increase in the number of eccrine glands. Clinicopathological correlation was paramount to achieve the diagnosis.

Cutaneous eccrine inflammation and necrosis: review of inflammatory disorders affecting the eccrine apparatus including new associations.

Despite being frequently overlooked during the examination of histopathological sections, eccrine sweat glands can offer clues for diagnosing various skin conditions. They provide important functions and can lead to several diseases when inflamed or injured. This review article provides information regarding eccrine physiology as well as well-established and novel entities that occur in association with eccrine gland pathology.

Poroid hidradenoma of the scalp.

Poroid hidradenoma has both features of hidradenoma and poroma. The histological hidradenoma framework consisting of solid and cystic components, and the presence of poroid and cuticular cells resembling a poroid neoplasm. Despite transforming into malignant neoplasm only in < 1% of cases, its histological characteristics may resemble those of malignant neoplasms. Although the risk of malignant transformation is very low, surgical excision is recommended to prevent growth and/or recurrence. To date, very few cases of poroid hidradenoma have been reported in the literature. Herein, we present a case of poroid hidradenoma on the scalp of a 74-year-old woman.

Pathological Changes in Axillary Hyperhidrosis and Axillary Osmidrosis Induced by Microwave Treatment: Comparison of Single- and Double-Pass Irradiation.

BACKGROUND AND OBJECTIVES: To analyze histopathological changes and degree of damage to the axillary tissue due to single- and double-pass irradiation therapy using a microwave energy-based device. STUDY DESIGN/MATERIALS AND METHODS: We included 15 axillary hyperhidrosis and axillary osmidrosis patients who received microwave irradiation therapy between March 2017 and March 2019. Ten patients underwent single-pass irradiation and five underwent double-pass irradiation, after which skin samples were collected from the right and left axillae for pathological analysis. Samples were taken in a consistent manner from Patient 6 onwards and a comparative study of five single-pass and five double-pass patients was conducted (n = 10). RESULTS: Histopathological analysis showed destruction and fibrosis in addition to necrosis and damage to the adipose tissue in apocrine and eccrine sweat glands. In the superficial microvasculature, blood vessel wall damage and thrombus formation were observed as well as damage in the hair follicles and hair bulbs. No obvious damage was observed in the epidermis and nerves. The amount of damage to sweat glands was higher in patients undergoing double-pass instead of single-pass irradiation. CONCLUSION: From a histopathological point of view, microwave energy-based irradiation therapy can be considered efficient, as there was no damage to epidermis and nerves and favorable destruction of apocrine and eccrine glands. As the amount of damaged sweat glands was higher after double-pass irradiation, it can be considered more effective than single-pass irradiation. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.

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.