Track

Case Reports

Abstract

Dermal hyperneury is a rare form of small nerve hypertrophy with exaggerated dermal nerve fibers. When multiple lesions are present, this entity has been associated with genetic syndromes such as multiple endocrine neoplasia 2B and 2A, neurofibromatosis type II, and Cowden syndrome. There have been cases of solitary or few lesions associated with trauma or skin cancer. This report describes a case of solitary dermal hyperneury to the upper back without known syndromic stigmata or previous trauma to the site. A 70-year-old female with a past medical history of skin cancer presented with a painful, 0.8 cm erythematous nodule to the mid upper back, present for an unknown amount of time. The initial presentation was consistent with a ruptured epidermal inclusion cyst. The patient was treated with intralesional triamcinolone and oral doxycycline for two weeks prior to punch excision. Histopathology revealed prominent and haphazard hypertrophic nerve bundles. A diagnosis of dermal hyperneury was made. Upon review, the patient had a history of microadenoma, found incidentally on stroke workup and not symptomatic. This case brings awareness to a rare neoplasm that can appear associated with syndromes or sporadically and is challenging to diagnose clinically.