Introduction Demographics Causes Clinical features Diagnosis Differential diagnoses Treatment and outcome
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Epithelial sheath neuroma is a rare benign cutaneous tumour composed of dermal nerve fibres surrounded by squamous epithelium [1,2].
Epithelial sheath neuroma has so far only been reported in 13 people; all have been older than 40 years of age. It has been reported most commonly in females [1].
The pathogenesis of epithelial sheath neuroma has not been determined, however several possible mechanisms have been suggested.
Epithelial sheath neuroma presents as a persistent erythematous papule or nodule located on the upper or mid-back. Some patients report tenderness, pruritus, or paraesthesia when the lesion is palpated [1].
Epithelial sheath neuroma is diagnosed by histopathological examination of a skin biopsy. It is characterised by multiple enlarged peripheral nerve fibres that are sheathed by mature squamous epithelium. Epithelial sheath neuroma is sometimes surrounded by myxoid (mucus-like) stroma and a lymphocytic infiltrate.
The clinical differential diagnosis for epithelial sheath neuroma may include:
The histological differential diagnosis for epithelial sheath neuroma includes reactive neuroepithelial aggregates, perineural invasion of a well-differentiated cutaneous carcinoma, or re-excision perineural invasion [7,8].
Epithelial sheath neuroma is benign.
The treatment of choice is excision, with no reports of recurrence after excision to date [1].
