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Subungual Eccrine Angiomatous Hamartoma: Description of a Novel Dermoscopic Feature

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Case presentation

A 45-year-old woman presented with a 2-month history of progressive tenderness at the tip of the left first toenail. Clinical examination showed no gross abnormalities within and beneath the nail plate. Nail plate dermoscopy revealed longitudinal yellowish-brown to yellowish-red areas with no remarkable changes in the nail plate, lunula, or proximal nail fold ( Figure 1A ). Histologic examination showed increased number of eccrine glands with irregular, dilated blood vessels ( Figures 1, B and C ), consistent with the diagnosis of eccrine angiomatous hamartoma (EAH).

Figure 1 .

(A) Nail plate dermoscopy revealed yellowish-brown to yellowish-red areas, which are arrayed longitudinally under the nail plate. (B, C) Histopathology showed the hamartomatous presentation of the lobules of the eccrine glands accompanied by abnormally dilated vessels. (H&E stain; original magnification: B, ×4; C, ×20.)

Teaching Point

EAH is a rare, benign combined eccrine and vascular malformation located mainly on the limbs, rarely in subungual areas. To our knowledge, this is the first report on nail plate dermoscopic descriptions of EAH. The presence of yellowish-brown to yellowish-red areas may reflect the numerous dilated eccrine glands and clusters of dilated capillaries among and around the eccrine glands, which could be helpful in its diagnosis [ 1 , 2 ] .

References

  1. Dermoscopy of eccrine angiomatous hamartoma: The popcorn pattern García García SC, Saeb Lima M, Villarreal Martínez A, et al. JAAD Case Rep.2018;4(2):165-167. CrossRef PubMed
  2. Dermoscopy of eccrine angiomatous hamartoma: The spitzoid pattern Kelati A, Chiaverini C, Giacchero D, Ilie M, Lacour JP, Bahadoran P. JAAD Case Rep.2018;4(8):835-836. CrossRef PubMed

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