Eccrine poroma of the heel

A 67‐year‐old African–American woman had a tender red nodule on the posterior aspect of her left heel of 20 years' duration. The lesion had initially grown quickly to its present size, but subsequently remained unchanged through the years. No previous history of trauma to the area could be elicited. The lesion was not tender or painful, although the patient related some recent discomfort when wearing shoes with high heel counters. Examination revealed a soft, multilobulated, skin‐colored nodule, measuring approximately 1.1 cm at its greatest diameter ( Fig. 1 ), with a rim space or moat ( Fig. 2 ) surrounding the lesion. Biopsy of the lesion demonstrated a uniform proliferation of basaloid cells exhibiting a sharp demarcation between the adjacent normal epidermis ( Fig. 3 ). No horn cysts were present. The papillary dermis demonstrated multiple ectatic blood vessels ( Fig. 4 ) which may be responsible for its reddish appearance.

Figure 1 Multilobulated, Open in figure viewer PowerPoint red, granulating lesion on the posterior heel