Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2022;12(4):e2022161 1

Subungual Eccrine Angiomatous Hamartoma: 
Description of a Novel Dermoscopic Feature

Takahiro Mizuta1, Nobuo Isono2, Miyuki Kato1

1 Department of Dermatology, Tokyo Metropolitan Tama Medical Center, Fuchu‐shi, Tokyo, Japan

2 Department of Plastic and Surgery, Tokyo Metropolitan Tama Medical Center, Fuchu‐shi, Tokyo, Japan

Citation: Mizuta T, Isono N, Kato M. Subungual Eccrine Angiomatous Hamartoma: Description of a Novel Dermoscopic Feature. 
Dermatol Pract Concept. 2022;12(4):e2022161. DOI: https://doi.org/10.5826/dpc.1204a161

Accepted: January 31, 2022; Published: October 2022

Copyright: ©2022 Mizuta al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, 
distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing interests: None.

Authorship: All authors have contributed significantly to this publication.

Corresponding author: Takahiro Mizuta, MD, Tokyo Metropolitan Tama Medical Center, 2‐8‐29 Musashidai, Fuchu‐shi, Tokyo 183‐8524, 
Japan. Phone: +81-42-323-5111, Fax: +81-42-312-9156 E-mail: t.miz.cof.lif2120@gmail.com

Case presentation

A 45-year-old woman presented with a 2-month history 

of progressive tenderness at the tip of the left first toenail. 

Clinical examination showed no gross abnormalities within 

and beneath the nail plate. Nail plate dermoscopy revealed 

longitudinal yellowish-brown to yellowish-red areas with no 

remarkable changes in the nail plate, lunula, or proximal nail 

fold (Figure 1A). Histologic examination showed increased 

number of eccrine glands with irregular, dilated blood vessels 

(Figures 1, B and C), consistent with the diagnosis of eccrine 

angiomatous hamartoma (EAH).

Teaching Point

EAH is a rare, benign combined eccrine and vascular 

 malformation located mainly on the limbs, rarely in sub-

ungual areas. To our knowledge, this is the first report on 

nail plate dermoscopic descriptions of EAH. The presence 

of yellowish-brown to yellowish-red areas may reflect the 



2 Image Letter | Dermatol Pract Concept. 2022;12(4):e2022161

Figure 1. (A) Nail plate dermoscopy revealed yellowish-brown to yellowish-red areas, which are arrayed longitudinally under the nail plate. 

(B, C) Histopathology showed the hamartomatous presentation of the lobules of the eccrine glands accompanied by abnormally dilated 

vessels. (H&E stain; original magnification: B, ×4; C, ×20.)

numerous dilated eccrine glands and clusters of dilated cap-

illaries among and around the eccrine glands, which could be 

helpful in its diagnosis [1,2].

Acknowledgments: We thank Editage (www.editage.com) 

for English language editing.

References

1. García García SC, Saeb Lima M, Villarreal Martínez A, et al. 

Dermoscopy of eccrine angiomatous hamartoma: The popcorn 

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JDCR.2017.08.014. PMID: 29387774.

2. Kelati A, Chiaverini C, Giacchero D, Ilie M, Lacour JP, Baha-

doran P. Dermoscopy of eccrine angiomatous hamartoma: The 

spitzoid pattern. JAAD Case Rep. 2018;4(8):835–836. DOI: 

10.1016/J.JDCR.2018.06.026. PMID: 30238051.