Poroma

From dermoscopedia

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Status update August 25, 2021
Status by Ralph P. Braun




Introduction and clinical features
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Poromas are uncommon benign tumors that are derived from the ducts of eccrine or apocrine sweat glands. They are often located on the volar surfaces of the hands or feet but can be found on any location of the body. Poromas usually present as a red to pink papule, nodule, or plaque. Other clinical features include an indented moat with collarette scale surrounding the lesion and a tendency to bleed with minor trauma [1][2].




Dermoscopy
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Dermoscopic features associated with poroma include branched vessels with rounded endings, white interlacing areas around vessels, yellow structureless areas, and milky-red globules [1]. Additional findings common but not specific for poromas include polymorphous vessels, blood spots, erosions/ulcers, and milky-red areas.





Dermoscopic features
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Branched vessels with rounded endings:

POROMA vessels.JPG

White interlacing areas around vessels:

POROMA white interlacing.JPG

Yellow structureless areas:

POROMA yellow structureless.JPG



Dermoscopic patterns
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Four dermoscopic patterns were described for poromas:

Pattern 1 - Appears most commonly on hands and feet and includes branched vessels with rounded endings, collarette of scale, blood spots, yellow structureless areas, milky-red globules and milky-red areas.

Pattern 2 – Appears on the trunk or non-acral extremities and includes polymorphous vessels, white interlacing areas around vessels, and branched vessels with rounded endings.

Pattern 3 – Appears anywhere on the skin surface as a relatively small papule and is either without vessels or with branched vessels with rounded endings. Clinically, these lesions simulated nodular basal cell carcinoma (BCC) but dermoscopically they did not have BCC-specific features.

Pattern 4 - Appears anywhere on the skin surface as a relatively large keratotic plaque that is pigmented in up to a third of cases. It frequently exhibited blood spots, keratin/scale, and atypical hairpin vessels.



Differential diagnosis
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Clinical and/or dermoscopic differential diagnoses include [1][3][4][5][6]:

  • Melanoma
  • Squamous cell carcinoma
  • BCC
  • Seborrheic keratosis
  • Nevus
  • Skin metastasis
  • Pyogenic granuloma
  • Verruca
  • Collision tumor
  • Dermatofibroma
  • Pyogenic granuloma
  • Angioma.



References

  1. 1.01.11.2 Marchetti et al.: Dermoscopic features and patterns of poromas: a multicentre observational case-control study conducted by the International Dermoscopy Society. J Eur Acad Dermatol Venereol 2017;. PMID: 29194789. DOI.
  2. Ferrari et al.: Eccrine poroma: a clinical-dermoscopic study of seven cases. Acta Derm. Venereol. 2009;89:160-4. PMID: 19326001. DOI.
  3. Lallas et al.: Eccrine poroma: the great dermoscopic imitator. J Eur Acad Dermatol Venereol 2016;30:e61-e63. PMID: 26333195. DOI.
  4. Bombonato et al.: Pigmented eccrine poroma: dermoscopic and confocal features. Dermatol Pract Concept 2016;6:59-62. PMID: 27648386. DOI.
  5. Espinosa et al.: Dermoscopy of non-pigmented eccrine poromas: study of Mexican cases. Dermatol Pract Concept 2013;3:25-8. PMID: 23785633. DOI.
  6. Minagawa & Koga: Dermoscopy of pigmented poromas. Dermatology (Basel) 2010;221:78-83. PMID: 20516657. DOI.