Sorafenib-induced Syringoma-like Eccrine Duct Proliferation in a Patient with Hepatocellular Carcinoma

Lee, Joon Bum; Lee, Kyu Suk; Oh, Byung Ho; Kim, Sung Ae

Abstract

Syringomas are common benign neoplasms that are derived from the intradermal eccrine duct and frequently manifest in adult females as 1~3-mm flesh-colored papules on the face, especially on the lower eyelid. There are two hypotheses about their pathogenesis: ductal obstruction by keratin plugs and reactive eccrine proliferation following an inflammatory condition. The patient was a 66-year-old man with multiple erythematous papules and nodules on both periorbital areas after 7-day sorafenib (Nexavar®) treatment. A skin biopsy of the Rt. periorbital lesion revealed multiple cysts and tadpole-shaped tubular structures in the dermal layer. Inflammatory cell infiltration was seen throughout the dermis. Based on the clinical features and histological findings, we diagnosed the patient with syringoma-like eccrine duct proliferation. The indications for and use of Sorafenib have increased recently. Although sorafenib-associated cutaneous side effects have increased, no cases of syringoma-like eccrine duct proliferation have been reported to date. Here we report a case of sorafenib-induced syringoma-like eccrine duct proliferation in a patient with hepatocellular carcinoma.