Pathogenesis

Mammary variant: underlying intraductal carcinoma of the breast with retrograde extension into the overlying epidermis through mammary duct epithelium; tumor cells derive from luminal lactiferous ductal epithelium of the breast tissue Extramammary variant: in most cases, arises as a primary cutaneous adenocarci-

Palmoplantar Hyperhidrosis 437

noma; epidermis is infiltrated with neoplastic cells showing glandular differentiation; tumor cells sometimes originate from apocrine gland ducts or from keratinocytic stem cells

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