Eccrine syringofibroadenomatosis in two patients with bullous pemphigoid

A 67-year-old man and an 84-year-old woman developed palmoplantar erythema following resolution of bullous pemphigoid (BP). Clinical manifestations of the palmoplantar lesions in these 2 patients ranged from prominent, well-demarcated erythematous areas with focal erosions and fissures to mild erythema. On histological examination, the palmoplantar erythema in one patient showed thin reticular strands of proliferating cells which connected with the epidermis and extended into the dermis, interwinding and anastomosing irregularly. The second patient showed similar mild changes with duct-like luminal formations. These histological findings were consistent with the diagnosis of eccrine syringofibroadenoma (ESFA). We speculate that these lesions developed as a result of the underlying inflammatory process in BP and conclude that ESFA associated with an inflammatory condition should be considered a new category of ESFA.