Limping Child with a Painful Sweaty Blue Patch on Foot: A Case of Eccrine Angiomatous Hamartoma

A 9-year-old limping boy presented with a painful blue lesion on his right foot for the past 2 years. On examination, a single well-defined bluish-grey tender plaque of size 2 × 2 cm was present on the right foot with tiny droplets of sweat seen over it [Figure 1]. The starch iodine test was positive. Dermoscopy showed numerous blue-brown globules with pseudo-reticular depigmentation surrounding the globules, suggestive of a spitzoid pattern [Figure 2]. Skin biopsy showed a proliferation of eccrine glands associated with thin-walled vessels [Figure 3]. On immunohistochemistry, the vascular endothelial cells were positive for CD-34. The case was diagnosed as eccrine angiomatous hamartoma, and surgical excision was done.Figure 1: (a and b) Single well-defined bluish-grey plaque of size 2 × 2 cm (1a- red arrows) with localised hyperhidrosis- multiple tiny droplets of sweat (1b)Figure 2: Dermoscopy showing numerous blue-brown globules (red arrow) with pseudo-reticular depigmentation around globules (blue arrow), suggestive of a spitzoid pattern. (DermLite DL3N, polarised, 10×)Figure 3: Photomicrograph showing increased eccrine glands in the mid-dermis. There is an increase in blood vessels of varying sizes between and around the eccrine glands and ducts. (Hematoxylin and eosin; 40×)Declaration of patient consent The authors certify that they have obtained all appropriate parent consent forms. In the form a parent has given their consent for her images and other clinical information to be reported in the journal. The parent understands that her name and initials will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. Use of artificial intelligence (AI) The preparation of this manuscript was carried out entirely by the authors without the use of artificial intelligence technologies.