eccrine angiomatous hamartoma ( eah ) is a benign enlargement of eccrine components , accompanied by abundance of vascular channels .
the anomaly is usually asymptomatic , but pain , hypertrichosis , and hyperhidrosis have been reported in a few patients .
a 26-year - old female presented with a 2.5 cm  1.5 cm blue - colored , ill - defined swelling over the dorsum of her left hand near the last intertriginous space encroaching over the ring finger .
the surface was irregular in texture and she could demonstrate small beads of perspiration on patting the lesion [ figure 1 ] .
this swelling was present for the last 2 years and she had sought medical aid as it was painful to touch . the adjoining skin over the 3 metacarpophalangeal joint and proximal interphalangeal joint of the 3 finger showed a skin - colored swelling and it represented an area of similar tumor which had grown slowly since birth .
a 4 mm punch biopsy was performed and the histopathology revealed lobulated , unencapsulated structure composed of mature , numerous eccrine glands enmeshed in loose connective tissue [ figure 2 ] .
blood vessels could not be demonstrated with the eccrine coils in the specimen [ figure 3 ] .
beads of perspiration on eccrine angiomatous hamartoma lobulated structures in the dermis showing eccrine glands ( h and e , 100 ) plentiful eccrine coils without blood vessels ( h and e , 400 )
such angioma was first described by lotzbeck in 1859 and termed as eah by hymann and colleagues in 1968 .
clinically , the lesion presents as solitary , bluish , or skin - colored nodules or plaques usually over the extremities as trauma may be an inciting factor .
numerous lesions in the same individual can be the result of mosaicism of a gene mutation occurring in the early developmental stage .
the tumor is painless , but involvement of nerve fibers by the enlarging eccrine elements can result in tenderness .
sudoriparous angiomas , as they are also known as , can display increased eccrine sweat production on exercise or when lightly stroked .
it has been suggested that as yet an unclear chemical interaction between the differentiating epithelium and the mesenchyme leads to the abnormal proliferation of eccrine structures .
the tumor has to be differentiated from other structures like tufted angiomas , capillary hemangiomas , smooth muscle hamartomas , and dermatofibromas .
dilatation of eccrine coils is a constant feature with amplification in their numbers , but associated enlargement of vascular channels may not be present . this modification has been termed 
 apart from closely entwined pilar structures and infiltration of adipose tissue , profuse deposition of mucin in the connective tissue has been detailed in the literature .
carcinoembryonic antigen ( cea ) and s-100 protein , which are commonly found in the eccrine sweat apparatus , are found to be diminished .
simple surgical procedures like excision have produced excellent results where it was sought for pain or for cosmetic reasons .
associations of such eccrine hamartomas are not common . a case with cowden 's syndrome , who had developed a thyroid adenoma , and another with neurofibromatosis are the only two such reports .
eah are rare malformations presenting diverse clinical and histological deviations which need differentiation from other complex tumors .
they carry a good prognosis and treatment is simple , often providing complete gratification for the sufferer .
 hamartomatous , circumscribed swellings of the extremities make an interesting study . presentations are manifold and the naevi are not always present from birth 
 . excessive growth of hairs leads to remarkable appearance of such swellings . 
 a young woman presented to the dermatology department , complaining of tenderness over 4th finger of her left hand . 
 the defect was present for the last couple of years and was typified by visible hyperhidrosis on gentle tapping . 
 counseling of the affected lady made her agree for a skin biopsy . 
 the histopathology revealed it to be of the nature of eccrine angiomatous hamartoma . 
 blood vessels were scarce . 
 eccrine ducts were plentiful without other associated anomalies . 
 the deformity was removed by simple excision with good result . 
Introduction
Case Report
Discussion