Refractory Chronic Ulcerative Eccrine Syringofibroadenoma Managed with Radiotherapy in a Patient with Ectodermal Dysplasia: A Case Report

Introduction

Eccrine syringofibroadenoma (ESFA) is a rare benign adnexal neoplasm that may present with chronic erosive or ulcerative lesions, particularly in patients with genodermatoses. Management of extensive or recalcitrant plantar disease is challenging. Case Presentation: A 50-year-old woman with odonto-onycho-dermal dysplasia due to compound heterozygous pathogenic WNT10A variants developed a painful, non-healing ulcer on the left heel persisting for three years despite conservative wound care. Histopathology and immunohistochemistry were diagnostic of ESFA. Intervention and Outcome: Owing to lesion extent and anticipated surgical morbidity, fractionated photon radiotherapy was delivered (66 Gy in 33 fractions). Treatment was well tolerated and resulted in gradual re-epithelialization with reduced exudate, substantial pain relief, and improved mobility at 6 months. A contralateral lesion that developed later responded similarly to repeat radiotherapy.