Er:YAG laser combined with botulinum toxin A for patients with local syringomas: A preliminary report.

Syringoma is a common but refractory benign skin tumor. Conventional treatment, such as ultra-pulsed carbon dioxide (CO2 ) laser or cryotherapy, often requires multiple treatment and can easily cause prolonged erythema, scarring, or depression, which are frustrating, so there is an urgent need to seek a safer and more effective method. In this article, we tried to demonstrate the Er:YAG laser combined with botulinum toxin A (BTXA) as a safer and more efficacious method for treating syringomas. MATERIALS AND METHODS: Twenty-one patients with local syringomas were treated with erbium laser ablation. Immediately after laser treatment, approximately 10 units of BTXA were sprayed on the wound for 10 min. RESULT: In total, 21 patients underwent 1.62 ± 0.74 treatments; their Periorbital Syringoma Severity Index (PSSI) score declined from 4.19 (before treatment) to 1.10 (after treatment), and the number of treatments was significantly lower than those reported in previous literature using the erbium laser alone. CONCLUSION: The Er:YAG laser combined with botulinum toxin A for the treatment of syringoma is a safer and more effective treatment than traditional treatment methods.

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.

Solitary Vulvar Syringoma With Deep Extension; Potential for Misdiagnosis as the Microcystic Adnexal Carcinoma (MAC).

ABSTRACT: A 43-year-old woman presented with a palpable, pruritic, minimally painful right vulvar lesion. Physical examination revealed approximately 2.0-cm tender nodule at 70' clock in the right labia majora. Histological sections of the excision specimen showed an unremarkable epidermis with large, well-circumscribed dermal proliferation with extension to the reticular dermis. Within this proliferation are small solid and ductal structures relatively evenly distributed in the sclerotic stroma. The epithelial elements consisted of monomorphous cuboidal cells and assumed round, oval, curvilinear, or have other peculiar geometric shapes, including "comma-like" or "tadpole"-like configurations. The tumor cells were positive for CEA, EMA, and estrogen receptor and negative for progesterone receptor. The clinical presentation and the deep extension of the tumor were similar to the microcystic adnexal carcinoma. Although a syringoma generally presents with multiple lesions and usually involves the superficial dermis, a syringoma with deep extension was favored based on the lack of follicular differentiation, atypia, mitoses, and perineural invasion. Microcystic adnexal carcinoma and syringoma have a morphologic overlap and are misdiagnosed in 30% of the cases. Thus, it is exceptionally important for pathologists to be aware of and be able to distinguish these entities. To the best of our knowledge, this is the first case of a solitary, painful vulvar syringoma with deep extension.

Syringomatous dermatitis: a myth or an existing entity?

Syringoma is rare disease that in classical variant occurs mainly on lower eyelids. In previously published researches, there is increasing evidence that eruptive syringomas must be discussed as an inflammatory dermal reaction pattern. And there was a proposal to change a name from eruptive syringoma to reactive syringomatous proliferation in appropriate cases. We conduct retrospective study on histopathological archived material to study the histopathological findings in cases of eruptive syringomas and correlate it with hypothesis that eruptive syringomas is not true adnexal neoplasms "de novo" but a hyperplastic response of the acrosyringium to an inflammatory process.According to obtained data and literature correlation, we can conclude that there is apparent diversity in eruptive syringomas. Part of cases can be calculated as neoplastic lesions arising "de novo," and another part as reactive syringomatous proliferation due to preceding cutaneous inflammatory process. Thus, term "eruptive syringoma" may be changed in appropriate cases to a "reactive syringomatous proliferation."Clinical variants of eruptive syringoma with evidence of underlying inflammatory process may be more responsive on types of treatments used for inflammatory disorders. Thus, more global clinicopathological correlative researches should be conducted and classification with terminology should be appropriately changed.

Clear Cell Syringoma of the Eyelids, a Distinctive Histopathologic Variant Associated with Diabetes Mellitus.

The authors describe the clinical and histologic findings of the clear cell variant of syringoma. Three adult female patients (age range 39-76 years old) were found to have multiple, flesh-colored lower eyelid papules, clinically consistent with syringomas, but histologically displaying abundant clear cell change. Two patients had known diagnoses of uncontrolled diabetes.

Eruptive syringomas: Summary of ninety cases and a brief literature review.

BACKGROUND: Eruptive syringomas is a rare variant of syringoma, which is a benign adenoma differentiated from the terminal ducts of the eccrine glands. Nowadays, it's widely valued because of obvious skin lesions, large scope of influence, and high misdiagnosis rate. OBJECTIVES: We aim to explore the clinical features of eruptive syringomas and the current research progress. MATERIALS AND METHODS: We firstly summarized the clinical features of 90 cases of eruptive syringomas. Then, the chi-square test was used to analyze the relationship between the onset site of eruptive syringomas and age, as well as gender. Finally, we briefly reviewed the previous literature. RESULTS: During 12 years, 90 cases of eruptive syringomas were diagnosed in our hospital, including 28 males (31.1%) and 62 females (68.9%). The average diagnosed age was 28.8. Patients from 20 to 40 years old is 63 (70%), which is the most. 60 (66.7%) patients had the course for more than 1 year. Among onset sites, the neck, chest, and abdomen were in the top three. The chi-square test showed that there were no significant differences in the onset sites of patients aged ≤ 20 and >20 years old (p-value = 0.181), as well as male and female (p-value = 0.363). CONCLUSION: We found that more female than male was affected, and the most common onset sites were the neck, chest, and abdomen. Neither age nor gender was significantly associated with onset site distribution. Our study provides some data support for the research of eruptive syringomas.

Syringomatous Adenoma of the Nipple with Associated Invasive Carcinoma: A Case Report.

Syringomatous adenoma of the nipple is a rare benign infiltrative neoplasm that was first described in 1983. At the time of this writing, a literature search revealed no cases of syringomatous adenoma of the nipple in association with invasive carcinoma of the breast. We report a case of syringomatous adenoma of the nipple in a 40-year old female who also had bilateral invasive ductal carcinoma and ductal carcinoma in situ of the breasts. Syringomatous adenomas of the nipple have been postulated to originate from eccrine structures of the nipple due to their microscopic similarity to other tumors of eccrine origin, such as syringomatous carcinoma. However, their exact origin is uncertain. Despite their benign behavior, they usually demonstrate an infiltrative and expansile proliferation into adjacent nipple and breast tissue. They have been confused with tubular carcinoma and low-grade adenosquamous carcinoma of the breast, both clinically and histologically. Complete excision is the therapy of choice, and only incompletely excised lesions have shown recurrence. We present this case to raise awareness that syringomatous adenoma of the nipple may present in patients with a simultaneous invasive carcinoma of the breast.

Efficacy and safety of lasers in treating syringomas: a review of the literature.

Syringomas are benign adnexal neoplasms that may induce psychological stress when they are large or disfiguring or present in delicate regions such as the periorbital area. Despite the availability of various lasers for syringomas, no consensus has been established on the optimal laser setting and side effects of these therapies. The current review aims at understanding the efficacy and safety of various laser therapies available for the treatment of syringomas. A literature search was carried out using PubMed and Ovid databases for articles published from Jan 2000 through Mar 2022. Screening the eligible articles yielded 27 studies, comprising clinical studies, case series, and case reports, which were included in this review. The CO2 laser is the most widely used ablative laser therapy but is usually associated with adverse events. Pinhole and multiple drilling methods using CO2 laser yielded excellent cosmetic results with minimal adverse effects. Fractional lasers reduced the downtime and complications compared to non-fractionated ones. Non-ablative fractional lasers could be advantageous in terms of easy operation, minimal side effects and moderate recovery period compared with ablative lasers. Large clinical trials are needed to generate strong evidence to guide clinicians in choosing the most appropriate laser therapy for syringoma treatment.

Rare syringoid eccrine carcinoma of the upper lip and nasal base treated with resection and subsequent innovative reconstruction using an Abbé flap, turbinate flaps and three-stage forehead flap: a case report.

BACKGROUND: Although syringoma is a common benign tumour of the sudoriferous gland, there is also an extremely rare malignant form known as syringoid eccrine carcinoma (SEC). SEC usually exhibits slow growth with deep invasion and a frequent tendency to relapse. The treatment of choice is radical wide resection, which poses a difficult reconstructive problem, especially when the tumour is located in the centre of the face. CASE PRESENTATION: In this case, a 70-year-old man was diagnosed with an SEC at the same location as a benign syringoma of the upper lip and nasal base that had undergone primary excision 7 years prior. Primary radical resection was performed with immediate Abbé flap reconstruction. Nevertheless, histology revealed positive margins, and 3 additional re-excisions were needed to achieve clear margins. Four months after the initial resection, the patient had undergone an innovative reconstruction technique including not only the Abbé flap but also a turbinate flap harvested with functional endonasal surgery and a three-stage forehead flap. CONCLUSION: To the best of our knowledge, this is the first case report of a suspect malignant transformation of a benign syringoma after 7 years. In addition, from oncoplastic and reconstructive points of view, the bilateral use of the turbinate flap for reconstructing the intranasal lining of the alar base is unusual, and the use of functional endonasal surgery in nasal reconstruction for reducing the risk of damaging the vascular supply of the flap is innovative.

Generalized Eruptive Syringoma in a Nigerian Woman: A Case Report and a Brief Literature Review.

Generalized eruptive syringomas are a very rare variant of syringoma which appear on the chest, neck, abdomen, upper and lower arms, thighs, legs and back. They often affect adolescent or post-adolescent females, although cases have been described in children and older adults. Generalized eruptive syringomas are mostly sporadic but familial cases, and those associated with eczematous skin conditions, solid organ transplants, renal cell carcinoma and some genodermatoses have also been reported. Although eruptive syringomas may resemble cutaneous mastocytosis, disseminated granuloma annulare, eruptive xanthomata, steatocystoma multiplex, eruptive velus hair syndrome, verruca plana and other skin conditions clinically, the histological appearance characterized by upper dermal epithelial cords with a tendency to ductule formation and tadpole extension of outer epithelial layer is diagnostic. We report the case of a 20-year-old Nigerian woman with generalized eruptive syringoma.