Case Letter
Reactive eccrine syringofibroadenoma triggered by thermal damage: case report
Roberto Rheingantz da Cunha Filhoa,
, Lucas José Quiocab, Graziela Junges Crescente Rastellic, José Fillus Netod
Autor para correspondência
a School of Medicine, Universidade do Oeste de Santa Catarina, Joaçaba, SC, Brazil
b Universidade do Oeste de Santa Catarina, Joaçaba, SC, Brazil
c Department of Pathology, Faculdade Evangélica Mackenzie Paraná, Curitiba, PR, Brazil
d Department of Basic Pathology, Biological Sciences Sector, Universidade Federal do Paraná, Curitiba, PR, Brazil
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"resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 433 "Ancho" => 750 "Tamanyo" => 43439 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Anatomopathological examination: anastomosing epithelial cords of cuboid cells forming trabeculae in fibrous stroma that extend from the epidermis to the deep dermis (Hematoxylin & eosin, ×20).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Eccrine syringofibroadenoma (ESFA) is a rare tumor that consists of the proliferation of ductal structures that resemble the acral portion of the eccrine sweat glands. It was first described by Mascaró in 1963, and there are just over 70 published cases in the literature.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> Although histologically distinct, the clinical presentation of ESFA is variable, from a solitary papule, plaque, or nodule to multiple lesions, with a predilection for the limbs of older patients.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> There is no consensus regarding its pathogenesis: tumor, hamartoma, or reactive hyperplasia.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> This report adds unprecedented aspects, as it demonstrates the association of ESFA with thermal damage and successful treatment using topical corticosteroids.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The authors report the case of a 71-year-old male, retired and without comorbidities. He reported the use of heat-generating plaster, consisting of iron powder, activated carbon, vermiculite, potassium chloride, and water (Fenaflan Patch®) to treat pain in the lateral region of the right thigh. However, there was a local reaction with burning and heat sensation, which caused the patient to remove the plaster before the indicated time. In the following days, he developed erythematous papules and a vegetating plaque, sometimes friable and bleeding, with mild pruritus. It progressed for three months, reaching the size of 4 cm (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). A 5-mm punch biopsy was performed. The anatomopathological examination revealed anastomosing epithelial cords of cuboid cells forming trabeculae embedded in fibrous and myxoid stroma, which were highly vascularized from the epidermis to the deep dermis. The diagnosis of reactive type ESFA was confirmed (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Clobetasol in 0.05% cream was administered with occlusive application once a day for 20 days, with a fully effective response. The post-inflammatory residual erythema resolved completely within a few months.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The most current classification of ESFA includes five subtypes: solitary; multiple without skin changes; nevoid associated with ectodermal dysplasia; multiple associated with Schöpf syndrome; and the reactive subtype, associated with neoplastic or inflammatory dermatoses.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The literature presents the occasional description with other entities, both inflammatory and neoplastic, including bullous pemphigoid, palmoplantar erosive lichen planus, psoriasis, congenital syphilis, nevus sebaceous, chronic skin ulcer, basal cell carcinoma, and squamous cell carcinoma.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The reactive type is probably triggered by tissue damage and, in the process of repair and remodeling, there is hyperplasia in response to the damage.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> However, this is the first report in the literature to associate thermal injury as the triggering factor for ESFA.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Histopathology assessment is necessary for diagnostic confirmation, the eccrine ducts may or may not be demonstrated. Immunohistochemistry can help in difficult cases, with cells often positive for keratin 6 and 19, as well as filaggrin.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">There is no consensus regarding treatment. The literature presents reports of etretinate therapy, surgery, radiotherapy, and laser; however, there are no reports of treatment with clobetasol or other topical corticosteroids.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The resolution of the present case occurred very quickly, with total regression in 20 days. The combination of the anti-inflammatory, antiproliferative, vasoconstrictor, and mitotic activity reduction effects of corticosteroids were probably determinant in the effective response to therapy.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0040" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors’ contributions</span><p id="par0045" class="elsevierStylePara elsevierViewall">Roberto Rheingantz da Cunha Filho: Approval of the final version of the manuscript; design and planning of the study; drafting and editing of the manuscript; collection, analysis, and interpretation of data; effective participation in research orientation; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases; critical review of the literature; critical review of the manuscript.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Lucas José Quioca: Approval of the final version of the manuscript; design and planning of the study; drafting and editing of the manuscript; collection, analysis, and interpretation of data; critical review of the literature; critical review of the manuscript.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Graziela Junges Ascending Rastelli: Approval of the final version of the manuscript; design and planning of the study; drafting and editing of the manuscript; collection, analysis, and interpretation of data; critical review of the literature; critical review of the manuscript.</p><p id="par0060" class="elsevierStylePara elsevierViewall">José Fillus Neto: Approval of the final version of the manuscript; design and planning of the study; drafting and editing of the manuscript; collection, analysis, and interpretation of data; effective participation in research orientation; critical review of the literature; critical review of the manuscript.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financial support" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Authors’ contributions" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-03-04" "fechaAceptado" => "2020-05-13" "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">How to cite this article: Cunha Filho RR, Quioca LJ, Rastelli GJC, Fillus Neto J. Reactive eccrine syringofibroadenoma triggered by thermal damage: case report. An Bras Dermatol. 2021;96:255–6.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Universidade do Oeste de Santa Catarina, Joaçaba Campus, SC, Brazil.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 564 "Ancho" => 750 "Tamanyo" => 33773 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Vegetating plaque and erythematous and pinkish papules grouped in the lateral region of the right thigh.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 433 "Ancho" => 750 "Tamanyo" => 43439 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Anatomopathological examination: anastomosing epithelial cords of cuboid cells forming trabeculae in fibrous stroma that extend from the epidermis to the deep dermis (Hematoxylin & eosin, ×20).</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 547 "Ancho" => 750 "Tamanyo" => 99171 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Anatomopathological examination: fibrous stroma in the middle and deep dermis (Hematoxylin & eosin, ×100).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Leprosy-associated eccrine syringofibroadenoma of Mascaro" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H.L. Tey" 1 => "W.S. Chong" 2 => "S.N. Wong" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Exp Dermatol." "fecha" => "2007" "volumen" => "32" "paginaInicial" => "533" "paginaFinal" => "535" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "World Health Organization Classification of Tumours: Pathology and Genetics os Skin Tumours" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. LeBoit" 1 => "G. Burg" 2 => "D. Weedon" 3 => "A.(orgs.) Sarasain" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2006" "editorial" => "IARC Press" "editorialLocalizacion" => "Lyon" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eccrine Syringofibroadenoma in a patient with erosive palmoplantar lichen planus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Le French" 1 => "E. Masgrau" 2 => "P. Chavaz" 3 => "J.-H. Saurat" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000245998" "Revista" => array:6 [ "tituloSerie" => "Dermatology." "fecha" => "1997" "volumen" => "195" "paginaInicial" => "399" "paginaFinal" => "401" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9529567" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reactive eccrine syringofibroadenoma arising in peristomal skin: An unusual presentation of a rare lesion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I.W. Mattoch" 1 => "N. Pham" 2 => "J.B. Robbins" 3 => "J. Bogomilsky" 4 => "M. Tandon" 5 => "S. Kohler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2007.08.032" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "2008" "volumen" => "58" "paginaInicial" => "691" "paginaFinal" => "696" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18342718" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eccrine syringofibroadenoma radiation treatment of an unusual presentation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.G. Morganti" 1 => "F.R. Martone" 2 => "G. Macchia" 3 => "A. Carbone" 4 => "G. Massi" 5 => "M. de Ninno" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Dermatol Ther." "fecha" => "2010" "paginaInicial" => "S20" "paginaFinal" => "3" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03650596/0000009600000002/v2_202104300920/S0365059621000052/v2_202104300920/en/main.assets" "Apartado" => array:4 [ "identificador" => "82769" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case Letter" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009600000002/v2_202104300920/S0365059621000052/v2_202104300920/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621000052?idApp=UINPBA00008Z" ]
| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 21 | 15 | 36 |
| 2024 Outubro | 129 | 72 | 201 |
| 2024 Setembro | 156 | 92 | 248 |
| 2024 Agosto | 200 | 118 | 318 |
| 2024 Julho | 189 | 111 | 300 |
| 2024 Junho | 146 | 71 | 217 |
| 2024 Maio | 112 | 67 | 179 |
| 2024 Abril | 118 | 87 | 205 |
| 2024 Março | 117 | 75 | 192 |
| 2024 Fevereiro | 114 | 84 | 198 |
| 2024 Janeiro | 64 | 45 | 109 |
| 2023 Dezembro | 75 | 69 | 144 |
| 2023 Novembro | 101 | 106 | 207 |
| 2023 Outubro | 71 | 79 | 150 |
| 2023 Setembro | 70 | 68 | 138 |
| 2023 Agosto | 67 | 28 | 95 |
| 2023 Julho | 59 | 40 | 99 |
| 2023 Junho | 66 | 44 | 110 |
| 2023 Maio | 51 | 19 | 70 |
| 2023 Abril | 62 | 12 | 74 |
| 2023 Março | 69 | 57 | 126 |
| 2023 Fevereiro | 56 | 41 | 97 |
| 2023 Janeiro | 40 | 41 | 81 |
| 2022 Dezembro | 45 | 34 | 79 |
| 2022 Novembro | 57 | 48 | 105 |
| 2022 Outubro | 115 | 65 | 180 |
| 2022 Setembro | 45 | 70 | 115 |
| 2022 Agosto | 43 | 46 | 89 |
| 2022 Julho | 44 | 57 | 101 |
| 2022 Junho | 47 | 57 | 104 |
| 2022 Maio | 33 | 49 | 82 |
| 2022 Abril | 39 | 54 | 93 |
| 2022 Março | 44 | 69 | 113 |
| 2022 Fevereiro | 24 | 34 | 58 |
| 2022 Janeiro | 53 | 72 | 125 |
| 2021 Dezembro | 43 | 68 | 111 |
| 2021 Novembro | 41 | 67 | 108 |
| 2021 Outubro | 54 | 79 | 133 |
| 2021 Setembro | 53 | 76 | 129 |
| 2021 Agosto | 43 | 65 | 108 |
| 2021 Julho | 43 | 52 | 95 |
| 2021 Junho | 78 | 80 | 158 |
| 2021 Maio | 127 | 97 | 224 |
| 2021 Abril | 402 | 267 | 669 |
| 2021 Março | 77 | 53 | 130 |
| 2021 Fevereiro | 15 | 15 | 30 |
| 2021 Janeiro | 3 | 2 | 5 |
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