Dermatology Online Journal

Eruptive syringoma
Sherry H Hsiung MD
Dermatology Online Journal 9(4): 14

From the Ronald O. Perelman Department of Dermatology, New York University

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Abstract

Eruptive syringoma is a rare eruption of small, flesh-colored papules that occurs in successive crops on the anterior body surfaces and arises in the peripubertal period. The lesions are benign, and treatment options are generally unsatisfactory. The case of a 27-year-old man with a 1-year history of eruptive syringoma is presented.

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Clinical summary

History.—A 27-year-old man presented with a 1-year history of a dermatosis involving the upper extremities, axillae, and anterior chest. The patient presented to the dermatology clinic at the Bellevue Hospital Center in January 2002, with an asymptomatic, generalized eruption of 1-year duration. The lesions appeared at the same time. He denies any medical problems or the use of over-the-counter preparations or prescribed medications. There is no one in his family who is similarly affected.

Physical examination.—Irregularly distributed on upper extremities and anterior chest were small, flesh-colored to light-brown papules. The lesions were monomophic.

Figure 1	Figure 2

Laboratory data.—None

Histopathology.—There is a dermal tumor composed of small ducts, some of which have comma-like-tails, and cords of basophilic epithelial cells embedded in a fibrous stroma. Ducts are lined by two rows of epithelial cells, and some have amorphous, keratinous material in their lumina.

Diagnosis.—Eruptive syringoma.

Comment

Syringomas are benign adnexal tumors of eccrine origin with four principal clinical variants [1]. The localized type presents with skin-colored to yellow, firm papules with a predilection for the periorbital region of women. Two types are familial and are associated with Down syndrome [2]. Eruptive syringoma is a rare variant, which has been described to occur in successive crops on the anterior body surface and usually presens before or during puberty [3, 4]. The eruptions are generally asymptomatic, although pruritus has been reported in some cases. The lesions are benign and may spontaneously resolve, or more commonly, remain stable.

Treatment of syringoma is cosmetic, and options are abundant and generally unsatisfactory. As they are located in the dermis and often numerous, physical techniques such as excision, electrocoagulation and liquid nitrogen cryotherapy yield poor cosmetic results [5, 6]. Oral isotretinoin and topical tretinoin and adapalene have been used as well ablative techniques such as the C0₂ laser have been reported with variable success; however, none eliminates the risk of recurrence.

References

1. Friedman SJ, Butler DF. Syringoma presenting as milia. J Am Acad Dermatol 1987;16:310.

2. Butterworth T, et al. Syringomas and mongolism. Arch Dermatol 1964;90:483.

3. Patrizi A, et al. Syringoma: a review of twenty-nine cases. Acta Derm Venereol (Stockh) 1998;78:460.

4. Pruzan DL, et al. Eruptive syringoma. Arch Dermatol 1989;125:1119.

5. Gomez MI, et al. Eruptive syringoma: treatment with topical tretinoin. Dermatology 1994;189:105.

6. Frazier CC, et al. The treatment of eruptive syringoma in an African-American patient with a combination of trichloroacetic acid and CO2 laser destruction. Derm Surg 2001;27:489.

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