Successful Treatment of Eccrine Angiomatous Hamartoma With Botulinum Toxin

A 12-year-old girl was referred to our department for evaluation of a 6-cm erythematous, brownish, indurated plaque that has been present on the sacral area since birth (Figure 1). The gluteal cleft was not deviated, and the lesion was not tender to palpation. The patient complained of profuse sweating that would drench her clothes. These symptoms were distressing and unrelated to emotional stress or physical exercise. A magnetic resonance imaging study revealed no lumbosacral spine abnormalities or cord tethering. A skin biopsy specimen demonstrated benign fibrovascular proliferation with a hyperplasia of the eccrine sweat glands in the dermis (Figure 2), which is consistent with an eccrine angiomatous hamartoma (EAH). The hamartomatous component was 2 mm below the epidermis and extended 4 mm into the dermis. In view of the symptoms, surgical excision was proposed, but the patient and her family preferred a different therapeutic approach.