Derm Dx: An enlarging erythematous nodule on the forehead - Clinical Advisor

Derm Dx: An enlarging erythematous nodule on the forehead

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A 43-year-old woman requests removal of a skin growth. The lesion has been enlarging slowly over the past 4 years, but when it was smaller, she said that it was “easily covered by my bangs.” She denies symptomatology, including pain and bleeding. Examination reveals a 3.0-cm erythematous nodule with prominent vasculature. No similar lesions are noted elsewhere, and cervical and occipital lymph nodes are nonpalpable.

A shave biopsy was performed and histopathology revealed spiradenoma. Spiradenoma is an uncommon adnexal tumor first described more than 60 years ago as a neoplasm of eccrine gland differentiation.1 There is no sexual predilection. Some cases have been linked to...

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A shave biopsy was performed and histopathology revealed spiradenoma. Spiradenoma is an uncommon adnexal tumor first described more than 60 years ago as a neoplasm of eccrine gland differentiation.1 There is no sexual predilection. Some cases have been linked to defects in a tumor-suppressive gene.2 Lesions are usually solitary and have a variety of hues, including gray, blue, pink, and red. Some tumors may be painful or elicit tenderness on palpation.

The majority of spiradenomas are benign and cured by simple excision. Malignant transformation is rare but occasionally reported.3 Cases of multiple spiradenoma in linear distribution have also been reported.2

Amy Hendrix, CRNP, is a nurse practitioner with Reading Dermatology Associates in Reading, Pennsylvania. Stephen Schleicher, MD, is an associate professor of medicine at the Commonwealth Medical College in Scranton, Pennsylvania, and an adjunct assistant professor of dermatology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. He practices dermatology in Hazleton, Pennsylvania. 

References

  1. Kersing DW, Helwig EB. Eccrine spiradenoma. AMA Arch Derm. 1956;73:199-227.
  2. Scheinfeld NS, Tarlow MM, Burgin S. Blaschkoid eccrine spiradenomas. Cutis. 2002;70:73-75.
  3. Dabska M. Malignant transformation of eccrine spiradenoma. Pol Med J. 1972;11:388-336. 
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