Abstract:

Coccygeal polypoid eccrine nevus (CPEN) has been described as a rare polypoid congenital hamartoma and unique variant of eccrine nevus. CPEN is historically asymptomatic and located in the coccygeal region with a female predominance. The histopathologic characteristics include a fairly unremarkable epidermis with occasional acanthosis and hyperkeratosis with an underlying dermal proliferation of eccrine glands in surrounding fibroadipose tissue. We present a case of a 19-year-old female with a history cranial facial dystosis and epilepsy who presented for removal of an asymptomatic skin tag present since birth. The lesion was a 5 mm flesh- colored papule located at the base of the right gluteal cleft. The initial clinical differential diagnosis included acrochordon, intradermal nevus and neurofibroma. Histopathologic sections showed a lesion with polypoid architecture. A proliferation of eccrine glands and ducts was identified within the reticular dermis. In addition, prominent nerve tissue was seen in association with the eccrine glands. This report represents the second case of CPEN occurring in a patient with other congenital anomalies and the first case of CPEN with nerve tissue hyperplasia.

Financial Disclosure:
No current or relevant financial relationships exist.

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Katelen Korty, DO