Cephalic eccrine poroma and clinical polymorphism: About two cases

Abstract

Eccrine poroma is a rare benign adnexal tumor originating from the intraepidermal portion of the eccrine sweat duct. While commonly found on acral sites such as the soles and palms, its occurrence in the cephalic region is rare and can lead to clinical misdiagnosis due to its resemblance to malignant lesions. This report presents two cases of cephalic eccrine poroma, each displaying distinct clinical and dermoscopic features. The first case involves a 47-year-old man with a dome-shaped, erythematous tumor on the scalp, previously treated for small cell carcinoma. Histological analysis confirmed eccrine poroma without malignancy. The second case is an 82-year-old woman with a keratotic plaque on the left temporal area, showing a polymorphous vascular pattern on dermoscopy. Histopathology again confirmed a benign eccrine poroma. Both lesions were excised completely with favorable outcomes. These cases highlight the clinical and dermoscopic polymorphism of eccrine poromas in atypical locations and underscore the importance of considering this diagnosis even outside classic acral areas. Due to its potential for malignant transformation, early recognition and complete excision are crucial. Histopathological confirmation remains the cornerstone for accurate diagnosis and management.