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Pigmented polypoid lesion on the neck
Corresponding author: Dr. Ozlem Ozbagcivan, Dokuz Eylul University, Faculty of Medicine, Department of Dermatology, Izmir, Turkey. ozlem. ozbagcivan@deu.edu.tr
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Received: ,
Accepted: ,
How to cite this article: Ozbagcivan O, Lebe B. Pigmented polypoid lesion on the neck. Indian J Dermatol Venereol Leprol. 2026;92:125-7. doi: 10.25259/IJDVL_438_2025
A 31-year-old woman presented with a progressively enlarging polypoid lesion on her neck over the past year. On physical examination, the lesion appeared as a 1.0 × 0.5 cm, firm, asymptomatic, brown mass with a smooth surface [Figure 1]. Dermoscopic evaluation revealed a polymorphic vascular pattern with structureless pink, whitish, and brown areas [Figure 2]. The lesion was completely excised, and histological analysis demonstrated poroid cuticular cell islands associated with the epidermis, along with small pore structures within the tumour [Figure 3], as well as cytoplasmic melanin hyperpigmentation in tumour cells located at the periphery of the tumour islands. [Figure 4]. In immunohistochemical analysis, focal ductal and cytoplasmic staining with epithelial membrane antigen [Figure 5a], focal ductal-luminal staining with Carcinoembryonic Antigen [Figure 5b] and rare nuclear staining with Ki67 were observed.
Question
What is your diagnosis?
Answer
Diagnosis: Pigmented polypoid eccrine poroma
Discussion
Eccrine poromas are benign adnexal tumours originating from the intraepidermal portion of eccrine sweat glands. They most commonly occur in acral regions, such as the palms, soles or lower extremities and typically present as skin-coloured or erythematous papules, plaques or nodules.1,2
Pigmented variants of eccrine poromas are exceedingly rare, particularly those with polypoid morphology. To date, only a few case reports have been published in the literature, involving the lower back, lower eyelids, and multiple sites, including the thigh, buttock, and face [Table 1].1-3
Polypoid forms of eccrine poromas have been associated with immunosuppressive conditions such as cancer, chemotherapy, and radiotherapy, with multiple lesions frequently reported in these cases.2 In the present case, however, a solitary polypoid lesion was observed on the neck without any history of immunosuppression. Clinically, the lesion resembled a skin tag, which complicated the initial diagnosis. Nonetheless, dermoscopy played a crucial role in the preliminary assessment, revealing polymorphic vascular patterns, including chalice-form and cherry-blossom vessels, along with structureless pink, whitish, and brown areas.4
The frequent occurrence of eccrine poromas in acral regions is attributed to mechanical, environmental, or immunological stressors.1 In our patient, the lesion developed on the neck, an area also vulnerable to localised friction and tactile trauma. This case may represent an example of an immunocompromised cutaneous district (ICD) following minor trauma, wherein the affected region becomes a “locus minoris resistentiae,” possibly due to an isotraumatopic response to subclinical trauma.5
Given the potential for malignant transformation into eccrine porocarcinoma, timely diagnosis, complete excision, and close follow-up are crucial in the management of eccrine poromas. This case highlights the importance of considering eccrine poromas in the differential diagnosis of hyperpigmented polypoid lesions, particularly in non-acral locations.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
References
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