Papular clear cell hyperplasia of the eccrine duct in a diabetic

We report a patient with a widespread papular disorder characterized by extensive clear cell hyperplasia of the secretory portion of the eccrine units. A 46-year-old woman had a long history of diffuse papules which gave the skin a 'goose-flesh' appearance. She had severe diabetes. Histological examination of a papule showed marked clear cell hyperplasia that involved the secretory duct of all eccrine units present in the specimen sparing the secretory coil. The clear cells were periodic acid-Schiff (PAS) positive and Alcian blue negative. Ultrastructural study. confirmed that: the clear cells contained abundant intracytoplasmatic glycogen. We suggest that the diabetic condition may be important in promoting the accumulation of glycogen in the eccrine ducts. Our patient represents a peculiar disorder of the eccrine units that, on the basis of clinicopathological features, we have termed papular clear cell hyperplasia of the eccrine duct.