Syringomas

Published on 05/03/2015 by admin

Filed under Dermatology

Last modified 22/04/2025

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Syringomas

DDx Ref       62126135

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Syringomas are the most common tumor of the intraepithelial eccrine sweat glands. Appear as asymptomatic flesh-colored papules.

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Syringomas occur on the eyelids, malar cheeks, axillae, anterior chest, abdomen, umbilicus, and vulva.

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The lower lids are the most common area for finding this appendage tumor. Lesions may be removed with curved scissors to improve appearance.

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Papules are usually symmetrically distributed and asymptomatic. May be extensive in Down syndrome and trisomy 21.

DESCRIPTION

Small, firm, skin-colored papules occurring most commonly in women around the eyelids, upper chest, and vulva. Syringomas are the most common tumor of the intraepidermal eccrine sweat glands.

HISTORY

• These appendageal tumors develop after puberty and increase in number throughout young adulthood. • Lesions are asymptomatic, stable in size and appearance, and persistent. • The autosomal dominant inheritance of multiple syringomas is well established. Syringomas occur with increased frequency in individuals with Down syndrome or trisomy 21. • Facial lesions are of cosmetic concern, and most patients request removal of larger lesions. • The patient may be concerned that the lesions are cancerous. • Women seeking evaluation of vulvar lesions may be concerned that the lesions are genital warts.

PHYSICAL FINDINGS

• Small, skin-colored to yellow, 1- to 2-mm, barely raised papules, most commonly found on lower eyelids. They also occur on malar cheeks, axillae, anterior chest, abdomen, umbilicus, and vulva. • Papules usually symmetrically distributed and asymptomatic. • Syringomas persist indefinitely and remain small. They have no potential for malignancy. • They may resemble flat warts or sebaceous hyperplasia.

TREATMENT

• Syringomas may be removed for cosmetic purposes. • Electrodesiccation and curettage, laser surgery, and trichloroacetic acid may be used, with variable success. • Sharp dissection or scissor excision of lesions is easily performed under local anesthesia. • All these procedures can lead to scarring, so care and precision are warranted. • In some patients, syringomas are too numerous to remove all lesions completely.