History

Poromas typically are asymptomatic, slow-growing, or stable nodular lesions.^[11]Although most are asymptomatic, pain can be a presenting sign. Poromas are one of many types of benign adnexal neoplasms that can manifest secondarily within a nevus sebaceus.^{[12, 13]}

Physical Examination

Poromas typically manifest as skin-colored papules or nodules smaller than 2 cm in diameter.^[14]Poromas may occasionally manifest as pigmented lesions.^[15]Protuberant lesions may exhibit surface erosion or ulceration. Rarely, a poroma manifests in association with nevus sebaceus as a secondary neoplasm.^{[12, 13]}Rabady et al reported a poroma arising on the eyelid.^[16]See the image below.

This vascular-appearing poroma presented on the tip of the toe.

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Differential Diagnoses

Alegría-Landa V, Kutzner H, Requena L. Cuticular Poroma: A Poroma Mostly Composed of Cuticular Cells (Cuticuloma). Am J Dermatopathol. 2018 Jul. 40 (7):e104-e106. [QxMD MEDLINE Link].
Kazakov DV, Kutzner H, Spagnolo DV, et al. Sebaceous differentiation in poroid neoplasms: report of 11 cases, including a case of metaplastic carcinoma associated with apocrine poroma (sarcomatoid apocrine porocarcinoma). Am J Dermatopathol. 2008 Feb. 30(1):21-6. [QxMD MEDLINE Link].
Harvell JD, Kerschmann RL, LeBoit PE. Eccrine or apocrine poroma? Six poromas with divergent adnexal differentiation. Am J Dermatopathol. 1996 Feb. 18(1):1-9. [QxMD MEDLINE Link].
McCalmont TH. A call for logic in the classification of adnexal neoplasms. Am J Dermatopathol. 1996 Apr. 18(2):103-9. [QxMD MEDLINE Link].
Chen CC, Chang YT, Liu HN. Clinical and histological characteristics of poroid neoplasms: a study of 25 cases in Taiwan. Int J Dermatol. 2006 Jun. 45(6):722-7. [QxMD MEDLINE Link].
Kakinuma H, Miyamoto R, Iwasawa U, Baba S, Suzuki H. Three subtypes of poroid neoplasia in a single lesion: eccrine poroma, hidroacanthoma simplex, and dermal duct tumor. Histologic, histochemical, and ultrastructural findings. Am J Dermatopathol. 1994 Feb. 16(1):66-72. [QxMD MEDLINE Link].
Chang O, Elnawawi A, Rimpel B, Asarian A, Chaudhry N. Eccrine porocarcinoma of the lower extremity: a case report and review of literature. World J Surg Oncol. 2011 Aug 22. 9:94. [QxMD MEDLINE Link]. [Full Text].
Kang MC, Kim SA, Lee KS, Cho JW. A case of an unusual eccrine poroma on the left forearm area. Ann Dermatol. 2011 May. 23(2):250-3. [QxMD MEDLINE Link]. [Full Text].
Kurashige Y, Yamamoto T, Okubo Y, Tsuboi R. Poroma with sebaceous differentiation: report of three cases. Australas J Dermatol. 2010 May. 51(2):131-4. [QxMD MEDLINE Link].
Marchetti MA, Marino ML, Virmani P, Dusza SW, Marghoob AA, Nazzaro G, 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. 2018 Aug. 32 (8):1263-1271. [QxMD MEDLINE Link]. [Full Text].
Göktay F, Güneş P, Akpolat ND, Ferhatoğlu ZA, Önenerk M. Periungual Eccrine Poroma Masquerading as Ingrown Toenails _{A Case Report with Dermoscopic Findings}. J Am Podiatr Med Assoc. 2017 Nov. 107 (6):551-555. [QxMD MEDLINE Link].
Barankin B, Shum D, Guenther L. Tumors arising in nevus sebaceus: a study of 596 cases. J Am Acad Dermatol. 2001 Nov. 45(5):792-3; author reply 794. [QxMD MEDLINE Link].
Jaqueti G, Requena L, Sanchez Yus E. Trichoblastoma is the most common neoplasm developed in nevus sebaceus of Jadassohn: a clinicopathologic study of a series of 155 cases. Am J Dermatopathol. 2000 Apr. 22(2):108-18. [QxMD MEDLINE Link].
Su P, Heng JK, Chen Wee Aw D, Tan KB. Characteristics of Eccrine Tumors in a Tertiary Institution: A 5-Year Retrospective Study. Skinmed. 2016. 14 (3):175-80. [QxMD MEDLINE Link].
Bombonato C, Piana S, Moscarella E, Lallas A, Argenziano G, Longo C. Pigmented eccrine poroma: dermoscopic and confocal features. Dermatol Pract Concept. 2016 Jul. 6 (3):59-62. [QxMD MEDLINE Link].
Rabady DZ, Carlson JA, Meyer DR. Poroma of the eyelid. Ophthal Plast Reconstr Surg. 2008 Jan-Feb. 24(1):63-5. [QxMD MEDLINE Link].
Altamura D, Piccolo D, Lozzi GP, Peris K. Eccrine poroma in an unusual site: a clinical and dermoscopic simulator of amelanotic melanoma. J Am Acad Dermatol. 2005 Sep. 53(3):539-41. [QxMD MEDLINE Link].
Minagawa A, Koga H. Dermoscopy of pigmented poromas. Dermatology. 2010 Aug. 221(1):78-83. [QxMD MEDLINE Link].
Mayo TT, Kole L, Elewski B. Eccrine Poromatosis: Case Report, Review of the Literature, and Treatment. Skin Appendage Disord. 2015 Sep. 1 (2):95-8. [QxMD MEDLINE Link].

Media Gallery

Poroma. Courtesy of Jeffrey Meffert, MD.
This vascular-appearing poroma presented on the tip of the toe.
This intradermal poroma (dermal duct tumor) shows a sharply circumscribed border at scanning magnification. Highly vascularized and focally sclerotic stroma is also evident.
At higher magnification, ductal differentiation is conspicuous.
This juxtaepidermal poroma presents histopathologically in continuity with the epidermis, creating a seborrheic keratosis-like profile.
At higher magnification, this poroma is composed of monomorphous small keratinocytes with "cuboidal" cytomorphology.
This poroma shows focal sebaceous differentiation, indicating that the lesion is of folliculosebaceous-apocrine (rather than eccrine) lineage.

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Poroma Clinical Presentation

History

Physical Examination

References

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