Eccrine nevus is a rare skin lesion with protean manifestations like hyperhidrosis, discolored nodules, papules, and so forth, which has been reported in various anatomic parts of the body including the forearm, leg, thigh, back, and coccyx. Our patient was a 26-year-old male, who presented with increasing colorless and odorless episodic umbilical discharge. First impression for the patient was an umbilical sinus and the patient underwent surgery. Histopathological study revealed the lesion to be an eccrine nevus of the umbilicus. This is the first case of eccrine nevus presenting with umbilical discharge. We recommend that eccrine nevus should be considered as a differential diagnosis for umbilical discharge.
Eccrine nevus is a rare skin lesion with protean manifestations [
We present a 26-year-old male with the chief complaint of umbilical discharge. The problem had started approximately 7 years ago with a gradual increase in the volume and frequency of colorless, odorless, watery-serous discharge. The discharge was recently happening several times a day, with each course lasting 10 to 15 minutes. The patient noted no exacerbating factor for the discharge and no umbilical discoloration or pain. He used to dry this discharge and manipulate the umbilicus with a towel several times a day. The past medical history was insignificant. On physical exam, he had normal vital signs with no fever. In abdominal exam, no erythema, tenderness, or odor was appreciated. Umbilicus was normal looking (Figure
Preoperation picture.
Polypoid lesion protruded to umbilicus covered by acanthotic epidermis.
Prominent increase in eccrine coils and dermal fibrosis.
Umbilical discharge can be the result of acquired pathologies, such as pilonidal sinus of umbilicus (suggested as the most common cause in one study), acute omphalitis [
Eccrine nevus is a rare lesion, with 20 cases reported till 2004, reviewed by Vázquez et al. [
Another review by Dr. Tempark and Shwayder [
Other interesting cases include a 3-month-old male with a congenital midline scalp lesion [
Summary of reported cases of eccrine nevus in literature.
Age | Congenital, 79 years old |
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Gender | 18 females (60%) |
12 males (40%) | |
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Location | Upper extremity: 13 (43%) |
Lower extremity: 9 (30%) | |
Trunk: 4 (13%) | |
Head: 4 (13%) | |
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Presenting signs and |
Hyperhidrosis: 12 (40%) |
Asymptomatic: 12 (40%) | |
Tenderness: 5 (16%) | |
Itching: 1 (3%) |
Etiology of eccrine nevus is unknown. The proposed pathogenic factors include congenital defects in embryogenesis, trauma, and stress, but none of them has been proven [
Treatment of eccrine nevus can be very challenging. Different methods have been used including surgery [
To the best of our knowledge, this is the second case of umbilical eccrine nevus and the first case of this kind with the chief compliant of umbilical discharge.
Thus, we recommend that eccrine nevus should be considered as a differential diagnosis of patients presenting with odorless, colorless, watery, nonbloody umbilical discharge, after excluding fistula, sinus, and infectious process. We strongly recommend a biopsy in all cases similar to our case.
The authors declare no conflicts of interest.