Treatment of periorbital syringomas with intradermal botulinum toxin A monotherapy versus carbon dioxide laser: a case report.

Syringomas are eccrine-derived benign adnexal neoplasms with the highest prevalence in early adulthood. They predominantly occur in females. They are commonly located on the face, particularly the lower eyelids, which have a high demand for cosmetic enhancement. Periorbital syringomas continue to pose a therapeutic challenge, with no consistently effective treatment available. Intradermal injection of botulinum toxin A is one of the new treatment modalities for periorbital syringomas. We report a case of periorbital syringomas in a 53-year-old female patient successfully treated using intradermal botulinum toxin A monotherapy as a painless cost-effective treatment that produced better long-term results than carbon dioxide laser.

Treatment of a case with giant eyelid syringomas.

He had a history of multiple asymptomatic flesh-colored papules, which had slowly increased in number and coalesced into plaques, on both upper and lower eyelids. Some of the plaques were giant and mostly coalescent in nature. We excised surgically the giant plaques which were approximately 1.5-2 cm in diameter symmetrically from upper and lower eylids and the remaining plaques were left to be treated with cauterization. Histopathological examination revealed syringoma. Both of the eyelids were observed to have a cosmetically adequate appearence after the surgical intervention.

Evaluation and management of the patient with multiple syringomas: A systematic review of the literature.

Syringomas are benign adnexal tumors with distinct histopathologic features, including the characteristic comma ("tadpole") shaped tail comprised of dilated, cystic eccrine ducts. Clinically, syringomas typically present in adolescent females predominantly in the periorbital region. They may present as solitary or multiple lesions, and more rare sites of involvement include the genitals, palms, scalp, and the chest. Over the past 50 years, there have been >800 reported cases of syringoma either alone or in conjunction with a systemic syndrome, most commonly Down syndrome. The primary aim of this systematic review is to discuss the clinical features and associations of syringomas with a focus on the patient with multiple syringomas. Its secondary aims are to explore pathophysiology with a focus on multiple syringomas and provide comprehensive data on both traditional and novel treatments. Importantly, multiple syringomas present across a broad clinical spectrum. Though noted in many textbooks to be related to tumor syndromes, the association of syringomas with inherited tumor syndromes is only rarely reported in the literature. Despite multiple reported cases of syringoma, the pathophysiology remains poorly understood and treatment continues to pose a significant challenge.

Carbon dioxide laser combined with botulinum toxin A for patients with periorbital syringomas.

BACKGROUND: Although various destructive methods have been described for treating syringomas, they are often associated with significant scarring and recurrence. In 2007, multiple-drilling method using carbon dioxide (CO2) laser was introduced as an alternative modality to gain good cosmetic results. OBJECTIVE: To retrospectively evaluate the effectiveness of CO2 laser combined with botulinum toxin A (BTXA) as treatment for syringomas. MATERIAL AND METHODS: Forty-eight patients with periorbital syringomas were treated with topical application of BTXA immediately after CO2 laser treatment. Forty-four patients were treated with CO2 laser only. RESULTS: Patients who were treated with CO2 laser combined with BTXA required significantly (p = 0.038) fewer treatment sessions compared with those treated with CO2 laser only. When the clinical improvements of the two treatment sessions were compared, the combined therapy (CO2 laser and BTXA) had significantly (p = 0.044) higher rate of results showing good (disappearance of 60-80% of lesion) or excellent (80-100%) than the CO2 laser only therapy (87.5% vs. 70.5%). CONCLUSIONS: CO2 laser combined with BTXA showed better effect than CO2 laser only.

Eruptive Syringoma in the Elderly: A Case Report.

Syringomas are benign tumors of adnexal origin, and eruptive syringoma is an extremely rare subtype. In this paper, we present a case of a unusual occurrence of eruptive syringoma in 66-year old woman that includes clinical and pathohistological findings and the review of the clinical picture, diagnosis, and treatment options.

Siringomas vulvar y palpebral en madre e hija / Vulvar and papebral syringoma in mother and daughter

Los siringomas son tumores anexiales frecuentes y asintomáticos que se presentan en mujeres jóvenes principalmente en párpados. La localización genital es poco frecuente, pero usualmente muy pruriginosa. Se presenta el caso de una paciente adolescente puérpera con múltiples siringomas vulvares pruriginosos, lesiones que también se encontraron en su madre, que era asintomática.

Syringomas are usually asymptomatic anexial tumors presents in young women principally in palpebral area. Genital localization is rare, but usually very pruritic. We present a case of a teenager in a post delivery period with multiple pruritic vulvar syringomas but we discover the same in her asymptomatic mother.

A case of zonal syringocystadenoma papilliferum of the axilla mimicking verruca vulgaris.

Syringocystadenoma papilliferum (SCAP) most frequently arises from an organoid nevus on the head and neck. Zonal or segmental lesions occurring in other locations are rare. Here, we report a case of a 39-year-old woman with an SCAP clinically mimicking verruca vulgaris in a zonal distribution on her right axilla after her birth. Histopathologic examination showed it to be a typical SCAP. Furthermore, the tumor had a warty surface, which histologically revealed some signs of viral infection. Although polymerase chain reactions for low- and high-risk human papilloma virus types were negative, the relationship of SCAP with viral infection needs further investigation.

Siringomas múltiples localizados: a propósito de un caso / Syringoma multiple locales: a report of a case

Los siringomas son tumores anexiales benignos que derivan del conducto sudoríparo ecrino. Suelen presentarse luego de la pubertad, con mayor incidencia en el sexo femenino. Se manifiestan clínicamente como pápulas rosadas pequeñas, localizadas en cara, cuello y región del escote. Las mismas son asintomáticas, aunque ciertos pacientes pueden referir prurito. La anatomía patológica de la lesión se caracteriza por proliferaciones epiteliales de dos líneas de células y, según el plano de corte, se puede observar la clásica imagen “en cola de renacuajo”. Existen numerosas alternativas terapéuticas para su tratamiento, si bien ninguna de ellas es totalmente satisfactoria. Presentamos el caso de una paciente adolescente, evaluada en nuestro servicio, con siringomas múltiples localizados.

Syringomas are benign adnexal tumors derived from eccrine duct. They occur predominantly after puberty with higher incidence in females. Clinically, they present as small rose-colored papules usually localized on the face, neck and upper aspect of chest. The lesions are generally asymptomatic, although some patients may complain of pruritus. Histopathology it is characterized by epithelial proliferation of two cell layers and, depending upon the plane of section, the classic tadpole appearance may be observed. Numerous treatment options exist, none of which are totally satisfactory. We report a case of a female adolescent with multiple localized syringomas that was seen in our Dermatology department.

Home study course: winter 2008.

OBJECTIVE: The Home Study Course is intended for the practicing colposcopist or practitioner who is seeking to develop or enhance his/her colposcopic skills. The goal of the course is to present colposcopic cases that are unusual or instructive in terms of appearance, presentation, or management or that demonstrate new and important knowledge in the area of colposcopy or pathology. Participants may benefit from reading and studying the material or from testing their knowledge by answering the questions. ACCME ACCREDITATION: The American Society for Colposcopy and Cervical Pathology (ASCCP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The ASCCP designates this education activity for a maximum of 1 AMA PRA Category I Credittrade mark. Physicians should only claim credit commensurate with the extent of their participation in the activity. The ASCCP also designates their educational activity for 1 Category 1 credit hour of the ASCCP's Program for Continuing Professional Development. Credit is available for those who choose to apply. The Home Study Course is planned and produced in accordance with the ACCME's Essential Areas and Elements. DISCLOSURE: The clinical history and images in the Home Study Course may represent an actual case, but not always. To improve educational quality, some gross, cytological, or histological images may come from photographic libraries. Good teaching cases are often difficult to obtain, and we encourage our readers to submit cases with high-quality images to the Home Study Course editor or executive editor to consider for publication. Lastly, faculty must disclose any significant financial interest or relationship with proprietary entities that may have a direct relationship to the subject matter. For this course, the authors had the following relationships to report: Gordon D. Davis, MD, FACOG: No such relationship to report Joseph A.D. Brooks, MD: No such relationship to report.

Syringoma: a clinicopathologic and immunohistologic study and results of treatment.

The purpose of our study was to describe clinical and histopathological features of sixty one patients with histological diagnosis of syringoma over four year period in our dermatology clinic in Korea. Female:male ratio was 6.6:1 with onset of age during 2nd and 3rd decades in more than half of the patients in our study. The most frequently involved site was eyelids (43 cases, 70.5%) and the most common color of lesion was skin-color (30 cases, 49.2%). In 34 cases, characteristic tad-pole appearances (55.7%) were observed. Basal hyperpigmentation was observed more frequently in brown-colored lesion (p=0.005). Fibrosis was observed more frequently in erythematous lesion (p=0.033). Keratin cyst was observed less frequently in genital involved group (p=0.006). We also performed immunohistochemical stain for the presence of progesterone receptor (PR) and estrogen receptor (ER) in fifty six cases with negative results.

Siringomas vulgares, patología frecuente en una localización infrecuente / Vulval syringomata, a frequent disease in a rare localization

Los siringomas son tumoraciones anexiales benignas bastante frecuentes en la población femenina de edad media, siendo la localización habitual la periorbitaria. Siringomas de localización vulvar han sido descritos cada vez más frecuentemente en la literatura, pero aún son considerados una patología inusual. Reportamos el caso de una mujer de 41 años que presentó múltiples siringomas vulvares, habiendo sido tratada por mucho tiempo sin éxito por prurito vulvar.