Cutaneous endometriosis is a rare condition where the endometrial cells are found in the skin, either spontaneously or following abdomino-pelvic surgery. Of women affected by endometriosis, cutaneous endometriosis accounts for only 0.5%-1% of cases.
The cutaneous condition begins with slow-growing, tender, reddish-brown papules or nodules of the skin and can cause cyclical pain associated with menses.
There are multiple theories regarding the pathophysiology of the cutaneous condition, including iatrogenic implantation of endometrial tissue into the skin, venous / lymphatic metastasis, and metaplasia. The most likely cause for cutaneous endometriosis occurring after abdomino-pelvic surgery (eg, cesarean delivery) is microscopic seeding at the excision site.
Related topics: Endometriosis, Endometriosis of lung
N80.6 – Endometriosis in cutaneous scar
35543003 – Cutaneous endometriosis
Differential Diagnosis & Pitfalls
The differential diagnosis includes:
- Dermatofibroma – Positive dimple sign.
- Dermatofibrosarcoma protuberans
- Melanoma – Usually more epidermal involvement and pigment.
- Basal cell carcinoma – Usually more epidermal involvement.
- Squamous cell carcinoma – Usually more epidermal involvement.
- Cutaneous metastases of cancer – Such as umbilical metastases (Sister Mary Joseph nodule).
- Hypertrophic scar (see scar)
- Lobular capillary hemangioma (pyogenic granuloma) – More friable.