Case Number : Case 707 - 1 Mar Posted By: Guest

Eccrine squamous syringometaplasia?

Appears reactive. ? Syringosquamous metaplasia. Needs clinicopathological correlation.

Another difficult case, mainly because I think there are two associated conditions. And a striking eccrine squamous syringometaplasia, secondary to these associated conditions, comes just to divert attention.
Blue dermal deposits may represent mucinosis.
Proliferation of small blood vessels and extravasated erythrocytes bring to mind stasis dermatitis.

Syringosquamous metaplasia...

Porocarcinoma

Pseudoep hyperplasias and syringosquamous metaplasia--reactive changes assoc. with stasis dermatitis.

Syringosquamus /pseudoepitheliomatous metaplasia

This is an exceedingly difficult case. I was very disturbed by the follicular
pattern of proliferation with engulfment of elastic (a feature typical of KA
and some poorly differentiated follicular SCC). I have generally only seen
the latter pattern in invasive tumours and not hyperplasia and on that basis
I raised the possibility of carcinoma. Clinical correlation was essential.
Reviewed at Skin MDM. Biopsy was 2 weeks from onset of the lesion.
Patient had previous episodes of trauma to lower legs but could not remember
anything specific. Lesion was a flatish brown patch in clinic reivew with
no clinically worrying features for malignancy. We decidided this was probably
a resovling KA-like proliferation / superficial lesion with prominent squamous
syringometaplasia and acroangiodermatitis. We adopted a watch and wait policy.
I would certainly be very cautious in such cases and don't be afraid to say
don't know!!
Regards to all and enjoy your weekends.

Very nice case :-) thanks a lot Dr Carr !!!!