Extraordinary Case ReportsAn Unusual Melanocytic Lesion Associated With Eccrine Duct Fibroadenomatosis and Syringoid FeaturesStefanato, Catherine M. M.D.; Simkin, David A. M.D.; Bhawan, Jag M.D.Author Information From the Dermatopathology Section, Department of Dermatology (C.M.S., J.B.), Boston University School of Medicine; and New England Medical Center, Tufts University (D.A.S.), Boston, Massachusetts. Address correspondence to Catherine M. Stefanato, M.D., Dermatopathology Section, Department of Dermatology, Boston University Medical Center, 609 Albany Street, Boston, MA 02118. This work was presented in part at the 36th Annual Meeting of the American Society of Dermatopathology, November 4–7, 1999, La Jolla, California. The American Journal of Dermatopathology: April 2001 - Volume 23 - Issue 2 - p 139-142 Buy SDC Abstract The intimate association of nevomelanocytic nevi with eccrine ducts commonly seen in congenital nevi was emphasized by Mishima, who described as eccrine-centered nevi those lesions characterized by nevomelanocytic cells predominantly proliferating around and within the eccrine sweat duct walls. However, there were no changes in the overlying epidermis, dermis, or eccrine acrosyringeal or dermal duct proliferation in these lesions. We present the case of a 16-year-old boy with a 1-year-history of a 0.6-cm diameter single tan papule on the right heel, clinically thought to be a Spitz nevus. Histopathologic examination revealed a compound nevomelanocytic nevus associated with epidermal hyperplasia, thin anastomosing cords of acrosyringeal epithelium extending within the dermis, and eccrine ductal proliferation in a syringoma-like pattern associated with a dense fibrous stroma. Features that distinguish our case from eccrine-centered nevus are that the latter lacks epidermal and eccrine duct hyperplasia and a dense fibrous stroma. The location of the lesion on the heel in our case suggests the possibility that the pathologic changes observed could result from repetitive trauma. © 2001 Lippincott Williams & Wilkins, Inc.