Mohs micrographic surgery for eccrine poroma

Eccrine poroma (EP) is a benign adnexal tumor that typically presents as a solitary, slow-growing lesion on acral sites, but recurrence and immunosuppression may increase the risk of malignant transformation. We report a recurrent EP in a 28-year-old man with chronic myeloid leukemia post-stem cell transplant on long-term immunosuppression. The patient presented with a moist, sessile, exophytic nodule on the thigh that had recurred six months after simple excision. Dermoscopy showed polymorphic vessels with interlacing white cords. Owing to recurrence and concern for porocarcinoma, Mohs micrographic surgery (MMS) was performed. Stage 1 margins revealed positivity between 3 and 6 o’clock, necessitating a second stage, after which margins were clear. Reconstruction was achieved with a keystone advancement flap. Histopathology confirmed benign EP. At 15-month follow-up, no recurrence was noted. This case highlights MMS as an effective tissue-sparing therapeutic option for recurrent EP in immunocompromised patients.