How to treat Syringomas?
What are Syringomas?
Syringomas are common benign sweat gland tumors (eccrine or apocrine).
Which body parts are usually affected?
Syringomas are usually Found on periorbital area (most common site), cheeks, scalp, forehead and the neck. They also can occur on upper trunk (Eruptive syringomas), genitalia, groin, buttocks, axillae, acral skin.
How Syringomas looks like?
Multiple discrete skin-colored to yellow papules.
Syringomas are pruritic or not?
Syringomas are mostly asymptomatic but in certain types like vulvar Syringomas, mild to severe pruritus may be present.
At which age Syringomas occur?
Syringomas may start to appear before or during puberty.
Who are more affected: men or women?
Women are more affected than men*.
What are the clinical types of Syringomas?
- Periorbital type (localized).
- Eruptive syringomas usually affect the neck, chest, abdomen, pubic area and may present on the buttocks.
- Acral Syringomas.
- Vulvar Syringomas : are present on the labia majora of women in the third decade of life.
- Penile Syringomas.
Diseases associated with Eruptive Syringomas?
- Down’s syndrome.
- Brooke-Spiegler syndrome.
- Nicolau-Balus syndrome.
- Marfan syndrome
- Milium.
- Elevation of carcinoembryonic antigen.
- Hyperthyroidism
- Diabetes.
- Psychiatric disorders.
- Ehler Danlos syndrome.
- Prurigo nodularis.
- Melanocytic nevi.
- Sarcoidosis.
What are the histopathological features of Syringomas?
Site of the pathology: Upper dermis.
Form of the pathology
- Multiple cystic ducts and epithelial cords lined by one or two layers of polygonal epithelial cells.
- Periodic acid-Schiff (PAS)-positive material usually fills the ducts` lumens
Special signs: Group of cells form coma-like tails projecting from one side of the duct into the surrounding stroma (Tad pole appearance).
How to treat Syringomas?
- The aim of the treatment is cosmetic.
Treatment options of Syringomas
Medical treatment options (case reports)
- Topical tretinoin.
- Topical atropine.
- Topical steroid (Vulvar Syringomas)
- Topical adelmidrol
- Oral isotretinoin.
- Oral tranilast.
Physical treatment options(Should be done carefully)
- Surgical excision.
- Diathermy.
- Cryotherapy
- Trichloroacetic acid applications.
- Punch excision.
- Co2 laser.
- Combination treatment.
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