Eccrine Nevus: Symptoms, Treatment Options, and Concerns - Dermatology

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Eccrine nevus, also known as eccrine acrospiroma or eccrine sweat gland tumor, is a benign skin lesion that arises from the eccrine sweat glands. These lesions can present as small, raised bumps on the skin, often appearing on areas such as the arms, abdomen, and face. While they are generally harmless, they can cause concern due to their appearance and potential for growth.


Symptoms
The symptoms of eccrine nevus typically include:
- Small, raised lesions on the skin, which may vary in color from flesh-toned to darker shades.

- The lesions can be smooth or have a rough texture.

- Some may experience localized discomfort or tenderness, especially if the nevus is irritated or inflamed.

In your case, it appears that you have observed a progression of these lesions over the years, with new ones developing and some changing in size or texture. This can understandably be concerning, especially when accompanied by a history of skin biopsies and treatments that have not yielded satisfactory results.


Treatment Options
Treatment for eccrine nevus is often not necessary unless the lesions become bothersome or are cosmetically unappealing. Here are some common treatment options:
1. Observation: If the lesions are asymptomatic and not causing any issues, many dermatologists may recommend simply monitoring them over time.

2. Surgical Excision: For lesions that are bothersome or have changed in appearance, surgical removal may be considered. This is especially true if there is any suspicion of atypical features.

3. Laser Therapy: Some patients have found success with laser treatments, which can help reduce the appearance of the lesions without the need for surgical intervention.

4. Cryotherapy: This involves freezing the lesions with liquid nitrogen, which can effectively remove them but may require multiple sessions.

5. Topical Treatments: While you mentioned having used oral isotretinoin and electrosurgery without success, some topical treatments may help with the appearance of the skin, although they may not eliminate the lesions entirely.


Concerns About Cancer and Other Changes
It is important to note that eccrine nevi are benign and do not typically undergo malignant transformation. However, any changes in the size, color, or texture of skin lesions should be evaluated by a dermatologist. Regular check-ups can help monitor any changes and ensure that no atypical features develop.


Recommendations
1. Regular Dermatological Check-ups: Given your history and the changes you've observed, it would be prudent to have regular follow-ups with a dermatologist. They can assess the lesions and determine if any further intervention is necessary.

2. Documentation of Changes: Keep a record of any changes in your skin lesions, including photographs, which can help your dermatologist in making informed decisions about your treatment.

3. Seek a Specialist: If you feel that your concerns are not being adequately addressed, consider seeking a second opinion from a dermatologist who specializes in skin tumors or lesions.

4. Stay Informed: Research and advancements in dermatology are ongoing. New treatments may emerge, so staying informed about your condition and treatment options is beneficial.

In conclusion, while eccrine nevus can be a source of concern, they are generally benign and manageable. Regular monitoring and consultation with a dermatologist can help you navigate your symptoms and treatment options effectively.