A clinicopathologic study of 18 eccrine acrospiromas with atypical nuclear changes is presented. The changes included nuclear pleomorphism, prominent nucleoli, chromatin condensation, multinucleate giant cells and increased mitotic activity. Of the 5 neoplasms that recurred, 2 recurred once and were histologically and clinically benign, and the other 2 recurrences were histologically malignant. One neoplasm recurred twice, the first recurrence being histologically benign and the second histologically malignant. It is suggested that such nuclear atypias in otherwise clinically and histologically benign eccrine acrospiromas may be associated with local benign recurrences some of which may undergo malignant change. Search for these nuclear changes and long follow‐up of patients in whom they occur are, therefore, recommende