A strange case of hairless plaque with excess sweating
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An 18-year-old male presented with an erythematous plaque on the left side of face, extending from angle of jaw to the lateral aspect of the neck since 4 years. The lesion was devoid of hair, had follicular prominences, and showed increased localized sweating. No pulsations were felt and no bruits were heard on auscultation. Systemic examination was unremarkable.

Histopathology revealed an increased number of eccrine glands in the myxoid stroma with multiple vascular elements in the dermis, favoring the diagnosis of eccrine angiomatous hamartoma. Immunohistochemistry was performed using CD31 immunostaining to delineate the presence of vascular elements in the dermis.

This is a case of eccrine angiomatous hamartoma (EAH).

Patient was explained that the lesion is benign explained and available therapeutic options including surgical excision were offered to him.

EAH is a benign lesion of hamartomatous origin, characterized histopathologically by proliferation of eccrine sweat glands and capillary-like vessels in the dermis. The disease shows no gender or racial predilection and primarily affects young children. It occurs due to faulty biochemical interactions between the differentiating epithelium and mesenchyme leading to abnormal eccrine and vascular proliferation have been proposed. Although EAH occurs usually on extremities and is associated with hypertrichosis, this case had clinical absence of hair and was present on face.

Source: https://www.idoj.in/article.asp?issn=2229-5178;year=2021;volume=12;issue=2;spage=368;epage=370;aulast=Kaushik