A Case of Scapular Hidradenoma Treated as a Keloid
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Summary: Hidradenomas are relatively rare benign tumors in the dermis that differentiate into eccrine or apocrine sweat glands. They often present as round or oval nodules and vary in color. Generally, they occur in the head and neck region. Keloid scars are often red, elevated lesions that are caused by chronic inflammation in the reticular dermis. These scars demonstrate a preference for high skin-tension sites, including the scapular region. Herein, we describe a case of a dark red hidradenoma on the scapular region with a high incidence of acne surrounding the lesion area that was initially diagnosed as an acne-initiated keloid. However, local steroid injection did not cure the lesion. After excision, histopathology revealed typical findings for hidradenoma, namely mucinous, polygonal, and clear cell composition. In some cases, as presented it may be challenging for clinicians to differentiate between hidradenoma and keloid due to the similar clinical features. Thus, hidradenoma should be taken in consideration as a differential diagnosis when encountering steroid-refractory keloid-like lesions. Moreover, early biopsy or surgical resection should be considered.Keywords:
Hidradenoma
Keloid
Apocrine
Keloid
Type I collagen
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Objective TO observe the therapeutic effect of axillary osmidrosis by excision of apocrine glands under the deep dermis with a mini-incision.Methods 180 patients with axillary bromidmsis were treated by excision of apocrine glands under the deep dermis,and all these patients were followed-up for long-term results.Results The total effective rate of 180 patients who were treated by excision of apocrine gland under the deep dermis was 100% after a follow-up period ranging from 6 to 12 months.Moreover,all the patients were with well-concealed inconspicuous scales and no axillary skin necrosis.Conclusions Excision of apocrine glands under the deep dermis via a small transverse incision might be the surgical treatment of choice for axillary osmidrosis with its high effectiveness and minimal invasiveness.
Apocrine
Axilla
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Several studies have reported on certain aspects of the characteristics of different sites within a keloid lesion, but detailed studies on the keloid dermis at different depths within a keloid lesion are scarce. The aim of this study was to investigate the histology of the keloid dermis at different depths. This study included 19 keloid tissue samples that were collected from 19 patients and 19 normal skin samples, which were harvested from subjects without keloids or hypertrophic scar. Samples were studied by light microscopy using routine hematoxylin and eosin histochemical staining, and immunohistochemistry to detect CD20-positive B-lymphocytes and CD3-positive T-lymphocytes. Sirius Red histochemical staining was used to determine the type of collagen in keloid tissue and normal skin samples. The migratory properties of fibroblasts within the keloid dermis at different depths was compared, using an in vitro migration assay. The findings of this study showed that although the papillary and reticular dermis could be clearly distinguished in normal skin, three tissue layers were identified in the keloid dermis. The superficial dermis of keloid was characterized by active fibroblasts and lymphocytes; the middle dermis contained dense extracellular matrix with large numbers fibroblasts, and the deep dermis was poorly cellular and characterized by hyalinized collagen bundles. In the keloid samples, from the superficial to the deep dermis, type I collagen increased and type III collagen decreased, and fibroblasts from the superficial dermis of the keloid were found to migrate more rapidly. In conclusion, the findings of this study showed that different depths within the keloid dermis displayed different biological features. The superficial dermis may initiate keloid formation, in which layer intralesional injection of pharmaceuticals and other treatments should be performed for keloid.
Keloid
Reticular Dermis
Papillary dermis
Sirius Red
Histology
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Abstract: A case of hidradenoma papilliferum with mixed features of syringocystadenoma papilliferum (SCAP) and anogenital mammary‐like glands is reported. A single, fresh red‐colored nodule developed in the sulcus between the labia majora and minora of a 49‐year‐old Japanese woman. Histopathologically, the tumor showed epithelial lining with apocrine secretion and slight connective tissues characteristics. Our case was unique because, like SCAP, the tumor was connected to the epidermis and cystic invaginations extended downward into the deep dermis. In addition, beneath the tumor, tubular structures that resembled normal mammary tissue were present in the subcutaneous fatty tissue. In this study, it has been suggested that this tumor might have been developed from these mammary‐like glands.
Apocrine
Hidradenoma
Labia majora
Nodule (geology)
Mixed tumor
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Abstract In the interest of developing an animal model for keloids, human keloid dermis was implanted in the subcutaneous tissues of athymic (nude) mice. Subsequent growth resulted in a lesion with histology similar to the original keloid. Fibroblasts were cultured from keloid dermis. When the fibroblasts alone were implanted in the subcutaneous tissues of nude mice, growth of a visible lesion was again produced. The fibroblasts had proliferated and deposited collagen in an abnormal fashion with the histology resembling the parent keloid. Further research could develop this into a reliable animal model to allow in vivo experimentation.
Keloid
Histology
Subcutaneous tissue
Nude mouse
Animal model
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Hidradenoma papilliferum of the anogenital region was previously believed to originate from apocrine glands but has recently been accepted as originating from anogenital mammary-like glands. We describe a case of hidradenoma papilliferum with mixed features of syringocystadenoma papilliferum and mammary-like glands from the left labia majora of a 25-year-old woman. Histopathologically, the lesion showed an epithelial lining with apocrine secretion, and like syringocystadenoma papilliferum, the lesion extended from the epithelium as invaginations into the dermis. Adjacent to this lesion were ductal and glandular structures resembling normal mammary tissue. This review of the literature highlights the heterogeneity and complexity of lesions arising from anogenital mammary-like glands, and this case serves as further documentation of the association between anogenital mammary-like glands and hidradenoma papilliferum.
Hidradenoma
Apocrine
Labia majora
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Objective This article aims to find a safe and effective method by excision of apocrine glands under the deep dermis.Methods Clinically,121 patients with axillary bromidrosis underwent excision of apocrine glands under the deep dermis and all these patients were followed-up for long-term results.Results For those 121 patients underwent excision of apocrine gland under the deep dermis,the total effective rate was 100% after a follow-up period ranging from 6 to 18 months with well-concealed inconspicuous scars and no axillary skin necrosis.The pathology histologic study proved that we cut off were apocrine glands.Conclusion Excision of apocrine glands under the deep dermis via a small transverse incision might be the surgical treatment of choice for axillary osmidrosis with its high effectiveness and minimal invasiveness.
Apocrine
Axilla
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Hidradenoma
Vulvar neoplasm
Anogenital distance
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Apocrine
Hidradenoma
Stain
Sebaceous gland
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Citations (33)
Hidradenoma
Apocrine
Nodule (geology)
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