Papular clear cell hyperplasia of the eccrine duct in a diabetic

We report a patient with a widespread papular disorder characterized by extensive clear cell hyperplasia of the secretory portion of the eccrine units. A 46-year-old woman had a long history of diffuse papules which gave the skin a 'goose-flesh' appearance. She had severe diabetes. Histological examination of a papule showed marked clear cell hyperplasia that involved the secretory duct of all eccrine units present in the specimen sparing the secretory coil. The clear cells were periodic acid-Schiff (PAS) positive and Alcian blue negative. Ultrastructural study confirmed that the clear cells contained abundant intracytoplasmatic glycogen. We suggest that the diabetic condition may be important in promoting the accumulation of glycogen in the eccrine ducts. Our patient represents a peculiar disorder of the eccrine units that, on the basis of clinicopathological features, we have termed papular clear cell hyperplasia of the eccrine duct.