Dermatopathology

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Eccrine Angiomatous Hamartoma with Concomitant Features of Folliculotropic T-cell Lymphocytosis

The patient is a 59-year-old male who presents with a subcutaneous plaque on the right cheek that has been present for approximately three years. It is neither painful nor itchy. The biopsy was performed of this right nasojugal area / right nasolabial fold plaque.

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Slide 1: This generous biopsy shows an unusual hamartomatous process within the mid and deeper dermis characterized by hyperplastic eccrine coils exhibiting significant apocrine metaplasia.

Slide 2: In addition, there are many blood vessels--specifically capillaries and venules--coursing through the adventitial dermis of these abnormal hyperplastic glands. In other areas within the deeper dermis the sudoriferous component is not discernible but rather there are variably sized blood vessels, primarily arteries, with interposed heterotopic fat. In addition, there is focal infiltration of the outer root sheath epithelium of the hair follicle, specifically the superficial to mid isthmic part of the follicle, by lymphocytes with some mild intercellular edema. There are no significant destructive epithelial changes.